Ruptured Cerebral Aneurysm Clinical Trial
Official title:
Cerebral Oxygenation and Metabolism in Patients Undergoing Clipping of Cerebral Aneurysm: A Comparative Study Between Propofol-based Total Intravenous Anesthesia and Sevoflurane-based Inhalational Anesthesia
Despite the theoretical benefits of i.v. agents, volatile agents remain popular. In a study
comparing desflurane, isoflurane, and sevoflurane in a porcine model of intracranial
hypertension, at equipotent doses and normocapnia, cerebral blood flow (CBF) and ICP were
least with sevoflurane.
Propofol is the most commonly used intravenous anesthetic. It has many theoretical advantages
by reducing cerebral blood volume (CBV) and ICP and preserving both autoregulation and
vascular reactivity. Neurosurgical patients anaesthetized with propofol were found to have
lower ICP and higher CPP than those anaesthetized with isoflurane or sevoflurane.
The well known pharmacodynamic advantages of intravenous anesthetics may give this group of
drugs superior cerebral effects when compared with inhalation anesthetics.
The aim of this study is to evaluate the cerebral hemodynamics and global cerebral oxygenation as well as the systemic hemodynamic changes using midazolam and propofol as total intravenous anesthetics (TIVA) in comparison with sevoflurane anesthesia in clipping of ruptured cerebral aneurysm. ;
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