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Original ArticleOpen Access
Propofol vs Isoflurane for Neurosurgical Anesthesia in Thai Patients
lttichaikulthol W 
,
Pausawasdi S ,
Srichintai P ,
Samvivad P
,
Pausawasdi S ,
Srichintai P ,
Samvivad P Sixty Thai patients, ASA class I-II, Glasgow coma score of 15 undergoing elective intracranial
surgery were randomly assigned to 2 groups. In group I, 30 patients were induced with
thiopental 3-5 mglkg, intubation with succinylcholine 1-2 mglkg and then maintained with 60 per
cent N20 in 0 2
, isoflurane and vecuronium as a muscle relaxant. In group II, 30 patients received
fentanyl 50 Jlg, propofol 1.0-2.5 mglkg for induction and vecuronium 0.08 mg!kg for intubation
then maintained with 60 per cent N20 in 0 2
, continuous infusion of propofol 2-12 mglkg/h and
vecuronium as a muscle relaxant. Controlled ventilation in both groups was set to maintain PET
C02 in the range of 28-35 mmHg. 3 patients (1 in group I and 2 in group II) were excluded from the
study due to surgical problems. There was no statistical difference in age, sex, ASA status,
weight, duration of anesthesia. Group II had a more stable systolic BP, Diastolic BP and Pulse
rate than Group I during induction and emergence from anesthesia. Glasgow coma scores in the
recovery period, Group II had higher scores than Group I at 5 and 15 minutes but not at 30 minutes.
Mean recovery times (eye opening) was 14.03±4.85 minutes in group I which is significantly
different from 10±5.17 minutes in group II. The cost of anesthesia in group II was 1.3 times that
of group I. In conclusion, although neurosurgical anesthesia for Thai patients with fentanylpropofol
technique produces more stable blood pressure during intubation and emergence, rapid
recovery from anesthesia and a higher Glasgow coma score, the cost of anesthesia IS more
expensive. Furthermore, this technique is more difficult and needs more experience.
surgery were randomly assigned to 2 groups. In group I, 30 patients were induced with
thiopental 3-5 mglkg, intubation with succinylcholine 1-2 mglkg and then maintained with 60 per
cent N20 in 0 2
, isoflurane and vecuronium as a muscle relaxant. In group II, 30 patients received
fentanyl 50 Jlg, propofol 1.0-2.5 mglkg for induction and vecuronium 0.08 mg!kg for intubation
then maintained with 60 per cent N20 in 0 2
, continuous infusion of propofol 2-12 mglkg/h and
vecuronium as a muscle relaxant. Controlled ventilation in both groups was set to maintain PET
C02 in the range of 28-35 mmHg. 3 patients (1 in group I and 2 in group II) were excluded from the
study due to surgical problems. There was no statistical difference in age, sex, ASA status,
weight, duration of anesthesia. Group II had a more stable systolic BP, Diastolic BP and Pulse
rate than Group I during induction and emergence from anesthesia. Glasgow coma scores in the
recovery period, Group II had higher scores than Group I at 5 and 15 minutes but not at 30 minutes.
Mean recovery times (eye opening) was 14.03±4.85 minutes in group I which is significantly
different from 10±5.17 minutes in group II. The cost of anesthesia in group II was 1.3 times that
of group I. In conclusion, although neurosurgical anesthesia for Thai patients with fentanylpropofol
technique produces more stable blood pressure during intubation and emergence, rapid
recovery from anesthesia and a higher Glasgow coma score, the cost of anesthesia IS more
expensive. Furthermore, this technique is more difficult and needs more experience.
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