title: Comparison of intraoperative brain condition, hemodynamics and postoperative recovery between desflurane and sevoflurane in patients undergoing supratentorial craniotomy.
abstract: BACKGROUND
  Post operative recovery has been reported to be faster with desflurane than sevoflurane anesthesia in previous studies. The use of desflurane is often criticized in neurosurgery due to the concerns of cerebral vasodilation and increase in ICP and studies comparing desflurane and sevoflurane in neurosurgey are scarce. So we compared the intraoperative brain condition, hemodynamics and postoperative recovery in patients undergoing elective supratentorial craniotomy receiving either desflurane or sevoflurane.
  
  
  METHODS
  Fifty three patients between 18-60yr undergoing elective supratentorial craniotomy receiving N2O and oxygen (60%:40%) and 0.8-1.2 MAC of either desflurane or sevoflurane were randomized to group S (Sevoflurane) or group D (Desflurane). Subdural intra cranial pressure (ICP) was measured and brain condition was assessed.. Emergence time, tracheal extubation time and recovery time were recorded. Cognitive behavior was evaluated with Short Orientation Memory Concentration Test (SOMCT) and neurological outcome (at the time of discharge) was assessed using Glasgow Outcome Score (GOS) between the two groups.
  
  
  RESULTS
  The emergence time [Group D 7.4 ± 2.7 minutes vs. Group S 7.8 ± 3.7 minutes; P = 0.65], extubation time [Group D 11.8 ± 2.8 minutes vs. Group S 12.9 ± 4.9 minutes; P = 0.28] and recovery time [Group D 16.4 ± 2.6 minutes vs. Group S 17.1 ± 4.8 minutes; P = 0.50] were comparable between the two groups. There was no difference in ICP [Group D; 9.1 ± 4.3 mmHg vs. Group S; 10.9 ± 4.2 mmHg; P = 0.14] and brain condition between the two groups. Both groups had similar post-operative complications, hospital and ICU stay and GOS.
  
  
  CONCLUSIONS
  In patients undergoing elective supratentorial craniotomy both sevoflurane and desflurane had similar intra-operative brain condition, hemodynamics and post operative recovery profile.
authors.affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Surya Kumar
authors.initials: SK
authors.lastname: Dube
authors.affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mihir Prakash
authors.initials: MP
authors.lastname: Pandia
authors.affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Chaturvedi
authors.affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Parmod
authors.initials: P
authors.lastname: Bithal
authors.affiliation: Department of Anesthesiology, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
authors.forename: Hari Hara
authors.initials: HH
authors.lastname: Dash
keywords: Desflurane; intracranial pressure; recovery; sevoflurane; supratentorial craniotomy
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