title: Superior recovery profiles of propofol-based regimen as compared to isoflurane-based regimen in patients undergoing craniotomy for primary brain tumor excision: a retrospective study.
abstract: OBJECTIVE
  Studies comparing the recovery profiles of isoflurane- and propofol-based anesthesia for major intracranial surgery have reported contradictory results. The aim of our study was to clarify the emergence status in both regimens by investigating uniformly managed neuroanesthesia cases.
  
  
  METHODS
  The anesthesia database at Yamagata University Hospital covering the period 2002-2005 was retrospectively investigated for adult patients who underwent craniotomy for primary brain tumor excision. General anesthesia was provided by an isoflurane- (ISO group) or propofol-based (PROP group) regimen. Times to extubation and operating room (OR) discharge, perioperative consciousness levels, and perioperative variables were compared.
  
  
  RESULTS
  Of the 202 surgeries performed during the study period, 77 and 82 patients were anesthetized with isoflurane and propofol, respectively. Demographic data were comparable between the two groups, although the American Society of Anesthesiology grade was worse in the PROP group. Extubation times [39.5 ± 14.6 min (ISO) vs. 29.5 ± 14.9 min (PROP); P < 0.001] and OR discharge times [67.2 ± 18.0 (ISO) vs. 53.9 ± 17.6 min (PROP); P < 0.001] were significantly shorter in the PROP, with significantly better immediate consciousness levels. The differences in levels of consciousness persisted for several hours postoperatively. PROP patients had significantly higher urine outputs and lower body temperatures during anesthesia. The incidences of shivering, nausea, vomiting, and convulsions were not significantly different between the groups. The time to discharge was similar between the groups.
  
  
  CONCLUSIONS
  Propofol was associated with a better recovery profile and neurological condition than isoflurane, as indicated by shorter extubation and OR discharge times and better postoperative consciousness.
authors.affiliation: Department of Dental Anesthesiology, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari-gun, Hokkaido, 061-0293, Japan. ymiura@hoku-iryo-u.ac.jp
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Miura
authors.forename: Kouhei
authors.initials: K
authors.lastname: Kamiya
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Okada
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakane
authors.forename: Airi
authors.initials: A
authors.lastname: Kumasaka
authors.forename: Kaneyuki
authors.initials: K
authors.lastname: Kawamae
mesh_terms: D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D018685:Anesthetics, Inhalation; D007530:Isoflurane; D015742:Propofol