A prospective, randomised, controlled clinical trial to evaluate the effect of nitrous oxide on propofol requirement in elective craniotomy in which entropy was used to measure depth of anaesthesia

Authors

  • Pragati Nanda Indraprastha Apollo Hospitals
  • Paramanand Prakash Indraprastha Apollo Hospitals
  • Kalyanpury Jawaharlal Choudhury Indraprastha Apollo Hospitals
  • Verandera Pal Singh Indraprastha Apollo Hospitals
  • Smita Prakash Indraprastha Apollo Hospitals

Keywords:

Nitrous oxide, propofol, anaesthesia depth, entropy, intracranial surgery

Abstract

Background: Propofol is known to have a favourable effect on cerebral haemodynamics. The role of nitrous oxide (N2O) in neurosurgical anaesthesia is still being debated. The primary aim of this study was to assess the dose-sparing effect of N2O on propofol infusion maintenance dosing. Method: Fifty American Society of Anesthesiology (ASA) grade I and II adults scheduled for elective craniotomies for supratentorial tumours were enrolled in the study. The patients received a standard anaesthetic comprising a fentanyl 2 μg/kg bolus prior to propofol induction. Anaesthesia was maintained with an infusion of fentanyl (2 μg/kg/hour), atracurium and propofol. The patients were randomised into two groups. Group A received 67% N2O. Group B did not receive N2O concomitantly with the propofol infusion. Entropy was used to guide the titration of the propofol infusion in both groups. Results: The propofol maintenance dose requirements were 47% lower in Group A (54.30 ± 11.47 μg/kg/minute) vs. Group B (102.30 ± 14.00 μg/kg/minute), (p < 0.001). Conclusion: The use of supplemental N2O significantly decreased propofol infusion rate requirements, compared with the propofol infusion alone, in ASA I and II patients undergoing elective supratentorial tumour excision. (Full text available online at www.medpharm.tandfonline.com/ojaa) South Afr J Anaesth Analg 2016; DOI: 10.1080/22201181.2015.1122708

Author Biographies

Pragati Nanda, Indraprastha Apollo Hospitals

Department of Anaesthesia and Intensive Care Indraprastha Apollo Hospitals New Delhi India

Paramanand Prakash, Indraprastha Apollo Hospitals

Department of Neuroanaesthesia Indraprastha Apollo Hospitals New Delhi India

Kalyanpury Jawaharlal Choudhury, Indraprastha Apollo Hospitals

Department of Neuroanaesthesia Indraprastha Apollo Hospitals New Delhi India

Verandera Pal Singh, Indraprastha Apollo Hospitals

Department of Neurosurgery Indraprastha Apollo Hospitals New Delhi India

Smita Prakash, Indraprastha Apollo Hospitals

Department of Anaesthesia and Intensive Care Indraprastha Apollo Hospitals New Delhi India

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Published

2016-03-16

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Section

Research Articles