Treated chronic hepatitis B is a good prognostic factor of diffuse large B-cell lymphoma

Background/Aims@#Chronic hepatitis B (CHB) is a risk factor for non-Hodgkin lymphoma (NHL). Our recent study suggested that antiviral treatment may reduce the incidence of NHL in CHB patients. This study compared the prognoses of hepatitis B virus (HBV)-associated diffuse large B-cell lymphoma (DLBCL) patients receiving antiviral treatment and HBV-unassociated DLBCL patients. @*Methods@#This study comprised 928 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at two referral centers in Korea. All patients with CHB received antiviral treatment. Time-to-progression (TTP) and overall survival (OS) were the primary and secondary endpoints, respectively. @*Results@#Among the 928 patients in this study, 82 were hepatitis B surface antigen (HBsAg)-positive (the CHB group) and 846 were HBsAg-negative (the non-CHB group). The median follow-up time was 50.5 months (interquartile range [IQR]=25.6–69.7 months). Multivariable analyses showed longer TTP in the CHB group than the non-CHB group both before inverse probability of treatment weighting (IPTW; adjusted hazard ratio [aHR]=0.49, 95% confidence interval [CI]=0.29–0.82, p=0.007) and after IPTW (aHR=0.42, 95% CI=0.26–0.70, p<0.001). The CHB group also had a longer OS than the non-CHB group both before IPTW (HR=0.55, 95% CI=0.33–0.92, log-rank p=0.02) and after IPTW (HR=0.53, 95% CI=0.32–0.99, log-rank p=0.02). Although liver-related deaths did not occur in the non-CHB group, two deaths occurred in the CHB group due to hepatocellular carcinoma and acute liver failure, respectively. @*Conclusions@#Our findings indicate that HBV-associated DLBCL patients receiving antiviral treatment have significantly longer TTP and OS after R-CHOP treatment than HBV-unassociated DLBCL patients.

Effect of Different Sounds on the Treatment Outcome of Tinnitus Retraining Therapy

OBJECTIVES: The purpose of this study was to evaluate the therapeutic effect of three different types of sounds on tinnitus patients undergoing tinnitus retraining therapy (TRT). METHODS: This is a single-institution retrospective study, performed in one tertiary otological referral center. Thirty-eight adults with subjective idiopathic tinnitus who were followed for at least 9 weeks were enrolled. Sound therapy was delivered in 3 different ways: narrowband noise TRT (nTRT); mixed band noise TRT (mTRT); broadband noise TRT (bTRT). Treatment response was measured through validated psychometric questionnaires: Tinnitus Handicap Inventory (THI), visual analog scale (VAS) on annoyance, and numerical description of hours of tinnitus perception (awareness hours). RESULTS: A total of 38 patients were followed for at least 9 weeks. In nTRT group, all outcome measures including THI, VAS, and the awareness hours, decreased over 9 weeks with no statistical significance. In mTRT group, all outcome measures except for awareness hours significantly improved 9 weeks after the beginning of the treatment. In bTRT group, all outcome measures decreased significantly in 9 weeks. When therapeutic success is defined as improvement in THI 7 or more, bTRT group (77.8%) showed a higher success rate than other groups for 38 patients with the minimum follow-up of 9 weeks. CONCLUSION: All three sounds can provide relief in patients with annoying tinnitus after TRT. However, there is difference in the therapeutic effect according to sound types. Broadband sound seems to be better than narrowband sound or mixed sound in relieving the patients from tinnitus. Therefore, sound therapy with broadband noise may be more appropriate during TRT, but further evidence is needed for precise conclusion.

Feasibility and Safety of Superolateral Sphenoidotomy: Radiologic Study by Analyzing Multiplanar Reconstructive CT Scans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The sphenoidotomy removing inferomedial side of anterior sphenoid wall has been the standard procedure to enter the sphenoid sinus. In this paper, we evaluated the feasibility and safety of superolateral sphenoidotomy based on the radiological analysis of the sphenoid sinus. SUBJECTS AND METHOD: Seventy-six multiplanar reconstructive computed tomography (CT) scans were reviewed to investigate dimensions of the sphenoid sinus. We measured the length from sphenoid ostium to optic canal and to carotid artery, and also measured the thickness of both upper and lower bony part of sphenoid ostium. The subjects were divided into two groups; one with sphenoid sinusitis and the other without sinusitis and all the measurements were evaluated and were compared between groups. RESULTS: The mean length from sphenoid ostium to optic canal were 13.8+/-2.4 mm in control group and 12.9+/-2.2 mm in sinusitis group. The length from sphenoid ostium to carotid artery were 10.4+/-1.5 mm and 10.0+/-1.8 mm in control and sinusitis group, respectively. There were significant differences in both lengths between control and sinusitis group. The bony thickness above and below the ostium were 1.48+/-0.31 mm and 1.73+/-0.27 mm respectively and were significantly different from each other (p<0.001). CONCLUSION: Since the neurovascular structures was relatively distant from the sphenoid ostium and the bony thickness below the ostium was significantly thicker than that above the ostium, the sphenoidotomy removing superolateral side of anterior sphenoid wall could be an alternative procedure, especially, in patients with a thickened bone around sphenoid ostium.

Long Term Results of Dacryocystorhinostomy in Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the long-term outcome of primary endoscopic dacryocystorhinostomy (DCR) or conjunctivo-dacryocystorhinostomy (CDCR) in adults with nasolacrimal duct obstruction. SUBJECTS AND METHOD: We retrospectively reviewed 31 eyes of 27 patients who underwent primary DCR or CDCR for anatomical or functional blockage of the lacrimal drainage system (4 males, 27 females, mean age 54.4+/-12.7 years). The mean follow-up period was 45.4+/-10.8 months. The main outcome measure for success was assessed by symptomatic improvement. Pre-operative CT findings and endoscopic findings, sites of obstruction, types of surgery, post-operative complications were evaluated and the outcome was assessed according to the level of obstruction and types of surgery. RESULTS: Two years after the surgery, the success rate was 83.9% including complete resolution of symptoms (64.5%) and partial improvement (19.4%). No improvement was reported in 16.1%. There was no significant difference in success rates of DCR according to the obstruction sites. Patients with functional blockage had worse success rate than those with anatomical obstruction. CONCLUSION: Both endoscopic DCR and CDCR had successful outcome in the long term con-trol of epiphora and functional nasolacrimal duct obstruction showed worse prognosis when compared with anatomical obstruction.

Short Term Effect of Mixed Tinnitus Retraining Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The long-term effect of tinnitus retraining therapy (TRT) is excellent while its short-term effect is known to be inferior to tinnitus making (TM). In this regard, we mixed TRT (mTRT) by combining TRT and TM to improve the short-term effect of TRT. This study evaluated the short-term effect of the mTRT and also compared the clinical efficacy between mTRT and TM. SUBJECTS AND METHOD: Twenty patients who underwent mTRT due to chronic subjective tinnitus were included in this study. Sound therapy of the mTRT was performed with mixed noise of broadband noise and narrow band noise. The broadband noise was used for TRT and the narrow band noise was used for TM. During the first month of mTRT, sound therapy was mainly composed of narrow band noise. During the second month, the proportion of broadband noise was gradually increased to 2/3. After 3 months, only the broadband noise was applied. Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) on annoyance and the tinnitus awareness duration (hr/day) was checked as the outcome measures. The outcome was also compared between mTRT and TM. RESULTS: The THI score decreased significantly from 41.8+/-24.3 to 27.3+/-25.6 after mTRT. The VAS (from 5.9+/-1.4 to 4.7+/-1.8) and the tinnitus awareness duration (from 18.5+/-8.2 to 12.6+/-10.7) also showed a significant improvement after treatment. When the treatment outcome was compared between mTRT and TM, there was no significant difference. CONCLUSION: mTRT seems to be effective in relieving the discomfort of tinnitus. Similar short-term outcomes can be expected from mTRT as they did in TM.

Resection of Impacted Bilateral Huge Frontal Osteoma Via Endoscopic Modified Lothrop Approach / 대한이비인후과학회지

Osteomas in the paranasal sinus had been usually treated with external surgical approaches. These techniques are effective in certain conditions such as large size or bilateral involvement of osteomas, with intracranial or orbital complications. This modality, however, have some disadvantages like permanent scar formation, bleeding, mucocele, and paresthesias. The authors recently experienced a huge impacted frontal osteoma, which completely involved the bilateral frontal recess without enough working space to mobilize the tumor. The huge bilateral impacted frontal osteoma was removed with endoscopic modified Lothrop approach due to cosmetic problems. We hereby report this case with a review of literature.

Clinical Analysis of Risk Factors Related to Recurrent Well Differentiated Thyroid Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Well differentiated thyroid carcinoma is the most common malignancy in thyroid gland. Most patients have an excellent prognosis. However, the recurrence of this disease carries a relatively high risk of tumor-related mortality. Therefore, the objective of this study is to analyze the factors that influence the development of well differentiated recurrent thyroid carcinoma. SUBJECTS AND METHOD: From January 1999 to January 2008, 366 patients who were diagnosed and surgically treated for well differentiated thyroid carcinoma were chosen. Disease free interval was assessed by univariate and multivariate analyses according to each prognostic factor. Prognostic factors consisted of sex, age, extra-capsular spread (ECS), multifocality, lymph node metastasis status, and extent of surgery. RESULTS: ECS and central, lateral LN involvement were significant risk factors for recurrence (p< 0.01). However, size of tumor, age, sex did not reveal any significance (p=0.20, p=0.73, p=0.60). In addition, multifocality, TNM staging showed borderline values (p=0.12, p=0.07). CONCLUSION: Extra-capsular spread and lymph node metastasis revealed high potential for recurrence of well differentiated thyroid carcinoma.

Clinical Characteristics of Dizziness after Motor Vehicle Accident / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Diagnosis and treatment of dizziness after motor vehicle accident (MVA) is not challenging. Psychological factors may be important and patient's quality of life can be underestimated due to nonspecific vague symptoms. The aim of this study is to reveal the clinical characteristics of dizziness after motor vehicle accident. SUBJECTS AND METHOD: Of the patients who have visited Dankook University hospital for traumatic dizziness from Jan. 1994 through Jan. 2008, we enrolled 51 patients who had history of motor vehicle accident and performed vestibular function test (VFT). Patients were divided into groups according to VFT findings. Patients who had unilateral hypo-function in VFT were classified as Group A. Patients who showed typical nystagmus for benign paroxismal positional vertigo (BPPV) were classified as Group B. And the others were classified as Group C who showed fair VFT results. RESULTS: Group C was found with unidentified dizziness, a tendency of late onset and long term recovery. Also they complained different distributions of their symptoms, that is, the rate of patients with headache and visual symptoms were higher in Group C. CONCLUSION: There were no remarkable characteristics in unidentified dizziness after MVA. Although the objective test results were non-specific, their clinical progress was not favorable. They complained of headache and visual symptoms more than other groups.

Bilateral Vestibular Hypofunction Induced by Unilateral Herpes Zoster Oticus

Herpes zoster oticus usually accompanies vestibulopathy on the ipsilateral ear. However we have encountered two herpes zoster oticus patients with bilateral vestibulopathies. Bilateral vestibulopathy was detected on the 2nd month and 19th day of herpes zoster oticus, respectively. While the contralateral vestibulopathy was detected 2 month after the ipsilateral vestibulopathy in the first patient, the vestibular function deteriorated simultaneously on the 19th day in the second patient. It seems that the bilateral vestibulopathy was caused by an autoimmune process in both cases, but the initiating event is different. The ipsilateral vestibular damage may have sensitized the immune system in the first patient resulting in sympathetic vestibulopathy. But in the second patient, the ipsilateral cochlear damage may have sensitized the immune system resulting in simultaneous bilateral vestibulopathy.

Internal Fixation of Clavicle Lateral and Fracture with Mini T-plate

PURPOSE: To evaluate the effectiveness of a mini T-plate fixation in clavicle lateral end fractures. MATERIALS AND METHODS: We reviewed eleven cases of calvicle lateral end fracture which were treated with open reduction and internal fixion with mini T-plate from May 2000 to December 2004. The follow up period was 12 months minimum. The radiologic result, pain and shoulder function were evaluated by the ASES shoulder score. RESULTS: All cases showed satisfactory results. Seven cases (63%) were excellent, and four (37%) cases were good. There were no fair or poor results. All cases showed radiologic union by the fifteenth week. No complications such as metal breakage, limited motion, infections were seen. CONCLUSION: This study demonstrates that using a mini T-plate fixation which is easy and induces no injury of acromiocalvicular joint, contributes to provide stable fixation in clavicle lateral end fractures.

Hemodynamic Responses and Changes in Oxygen Extraction When Using Amrinone, Dobutamine and Isoproterenol in Cardiac Tamponade-Induced Dogs / 대한마취과학회지

BACKGROUND: Cardiac tamponade is most commonly treated by needle aspiration or surgical drainage. During this process, it may be necessary to temporarily improve cardiac output and to maintain peripheral perfusion by using vasoactive drugs and volume expanders. The purpose of this study is to examine the hemodynamic effect along with oxygen availability on cardiac tamponade induced dogs caused by the use of dobutamine, isoproterenol and amrinone following pentastarch infusion. METHODS: Twenty-four dogs were divided into four groups including a control group (group I), which received only pentastarch 10 ml/kg after artifical tamponade was induced. Following the administration of pentastarch, group II (n = 6) received dobutamine by dripping 10 microgram/kg/min, and then by 20 microgram/ kg/min, group III (n = 6) received isoproterenal (0.5 microgram/kg/min, 1.0 microgram/kg/min) and group IV (n = 6) received amrinone (50 microgram/kg/min, 100 microgram/kg/min). The hemodynamic parameters were measured in seven intervals: baseline, thoracotomy, tamponade, tamponade plus pentastarch, pentastarch plus dripping (1st dose), pentastarch plus drug (2nd injection = two times the 1st dose), and pericardiostomy. Arterial and mixed venous blood gas analyses were carried out in three intervals: after thoracotomy, tamponade, pentastarch plus drug (infusion). Subsequently, oxygen extraction ratios were calculated from the oxygen delivery and oxygen consumption. RESULTS: The heart rate increased significantly during the infusion of isoproterenol (P = 0.032) 1.0 microgram/kg/min in group III and also during the dobutamine infusion when the pericardiostomy (P = 0.028) was performed in group II. Compared to the control group, cardiac output increased significantly in group II from the infusion of the 1st dose and also in group III with the 2nd dose infusion but there were no significant changes in group IV. Although the average intrapericardial pressure was 0.93 mmHg in each group and was increased to 8.23 mmHg during the induced tamponade, no significant changes occurred in the groups with drug infusion. The oxygen extraction ratio fell significantly in the groupII, III and IV during the drug infusion. CONCLUSIONS: As results of this study, it was concluded that the most effective hemodynamic improvements during the induced cardiac tamponade occured in group II with pentastarch-dobutamine while the least effective combination occurred in group IV with pentastarch-amrinone.

The Effect of General Anesthesia on Hemodynamics during Laparoscopic Hysterectomy / 대한마취과학회지

BACKGROUND: Laparoscopy with peritoneal carbon dioxide insufflation is a standard procedure in many gynecological departments. And more prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. Despite laparoscopic operations have many advantages, peritoneal insufflation of CO2 to create the pneumoperitoneum necessary for laparoscopy induces intraoperative hemodynamic changes that complicate anesthetic management of laparoscopy.The purpose of this study is to evaluate the effect of general anesthesia on hemodynamics during loparoscopic hysterectomy. METHODS: Twenty six women undergoing laparoscopic hysterectomy were randomly allocated to either a propofol (Group 1, n=13) intravenous anesthesia or a enflurane (Group 2, n=13) anesthesia with fentanyl-N2O/O2-vecuronium. Hemodynamic parameters were measured before induction (T1), 5 min after induction (T2), 5 min after head-down (T3), 5, 10, 15, 20 min after pneumoperitoneum (T4, T5, T6, T7), 5, 10 min after deflation (T8, T9). The MAP, HR, CI, SVRI, SI were measured by transthoracic electrical bioimpedence method and automated blood pressure device. RESULTS: The mean arterial pressure were increased during pneumoperitonem in both groups and heart rate were increased in Group 2. The cardic index were decreased in both groups after induction by 27.4 % in Group 1 and 25.7% in Group 2. The systemic vascular resistanace index were increased in both groups from head-down to after deflation by 68.3% in Group 1, 73.1% in Group 2 maximally. No significant changes of stroke index were observed during surgery in Group 1. CONCLUSIONS: Laproscopy with CO2 insufflation induces significant hemodynamic changes includig increases of MAP, SVR and a reduction of CI. And usual intraoperative hemodynamic monitoring; the blood pressure and heart rate give no information on the reduction in cardic output.

Anesthesia for Multiple Cerebral Aneurysms in a 7 Year Old Child with Ventricular Septal Defect: A case report / 대한마취과학회지

Multiple cerebral aneurysms in children are rare lesions, occurring at a frequency of approximately 0.5% to 4.6%. In children, infective endocarditis from congenital or rheumatic heart disease are the important causes of cerebral mycotic aneurysms. Subarachnoid hemorrhage, most commonly caused by the rupture of an intracranial anurysm is associated with mortality and morbidity. We reported a case of multiple cerebral aneurysms in a 7 year old child with ventricular septal defect (VSD) in operation of the two times performed under general anesthesia. He was scheduled for elective surgery for clipping of cerebral aneurysm in ASA physical status II. For premedication, he was administered triflupromazine 10 mg (Veprin ) and glycopyrrolate 0.1 mg IM 1 hour prior to induction. Induction was established with thiopental, vecuronium after preoxygenation. N2O/O2 (2 L/min:2 L/min), isoflurane and vecuronium were administered for maintenance. For monitoring, ECG, direct arterial pressure, CVP, ETCO2 were performed. In second operation, we were performed the general anesthesia the same as the first operation. He had discharged in coma state on 4 day after the second operation hopelessly.

Hemodynamic Changes Associated with Uterine Contraction under Obstetric Analgesia / 대한마취과학회지

BACKGROUND: Continuous epidural analgesia is the most widely used technique in obstetric analgesia today. Hemodynamic changes during pregnancy were most remarkable during the uterine contractions of the first stage of labor. The aim of this study was to compare the difference in hemodynamics between two groups with and without obstetric analgesia. METHODS: Twenty healthy parturients were divided into two groups as follows: Group 1; 10 parturients under epidural analgesia, Group 2; 10 parturients without epidural analgesia,and hemodynamic changes were monitored throughout labor. For the purpose of analysis, the course of labor was divided into three categories according to the degree of dilation of the cervix: 4 cm, 4~7 cm and above 7cm. Hemodynamic parameters were obtained during and in-between contractions over the course of labor through transcutaneous impedence cardiography and a noninvasive automatic blood pressure monitor. RESULTS: Heart rate (HR) in Group 2 were more increased than that in Group 1 during uterine contraction. In Group 1, the end-diastolic volume index (EDVI) and stroke volume index (SVI) at 4 cm dilation and SVI at above 7 cm dilation of the cervix were increased during the contraction. In Group 2, HR increased throughout the first stage of delivery and systolic blood pressure (SBP), EDVI at 4~7 cm and above 7 cm dilation and SVI at above 7 cm dilation were increased during contractions. CONCLUSIONS: Our study showed more stability in hemodynamic parameters in parturients under epidural analgesia as compared to those without analgesia. From these results, we conclude that continuous epidural analgesia is very safe to the fetus as well as mother since the technique dose not cause significant hemodynamic change during uterine contractions.

Brain Surgery for Epilepsy under Propofol I.V. Anesthesia / 대한마취과학회지

The treatment for epilepsy has been studied throughout the course of human history. However, radical treatment of epilepsy has only been discovered recently with introduction of surgical treatment until now, palliative drug administration was common practice. During the anesthetic procedure for epilepsy surgery it is necessary for the patient to be alert and to cooperate with the surgeon while mapping and subcutaneous EEG test are carried out during the surgery. For this type of procedure, a new I.V. anesthetic, propofol is considered to be an ideal anesthetic agent because propofol is a short-acting and clear headed I.V. anesthetic agent for induction as the well as the maintenance of genenral anesthesia. In this study, only propofol was administered intravenously in 20 randomiied patients scheduled for brain surgery for epilepsy treatment. The mean infusion rate was 100 mcg/kg/min to maintain a satisfactory anesthesia. For the induction of anesthesia, slightly higher doses were required. The cardiovascular effects of propofol infusion was associated with slightly decrease of systolic, diastolic and mean arterial pressures. Arterial blood gases were analyzed for the evaluation of ventilatory function. PaCO2 were 41+/-4.23 mmHg preoperatively, 44+/-5.28 mmHg 30 min. following sedation, 42+/-6.35 mmHg 30 min. following awakening, 46+/-6.37 mmHg 30 min. following resedation, 44+/-4.79 mmHg at 2 hours and 44+/-6.51 mmHg at 4 hours after resedation and 36+/-3.98 mmHg 30 min. following recovery. PaO2 were 101+/-31.3 mmHg preoperatively, 190+/-47.13 mmHg 30 min. following sedation, 195+/-32 mmHg 30 min. following awakening, 209+/-29.23 mmHg 30 min. and 210+/-34.55 mmHg at 2 hours and 190+/-37.36 mmHg 4 hours following resedation, and 10.2+/-31.36 mmHg 30 min. following. PH were 7.38 preoperatively, 7.34+/-0.04 following sedation, 7.34+/-0.03 30 min. following awakening, 7.34+/-0.03 at 30 min. following resedation, 7.35+/-0.03 at 2 hours and 7.36+/-0.03 at 4 hours following resedation, and 7.38+/-3.98 at 30 min. after recovery. The duration of anesthesia was 8.5-12 hours. The duration of propofol anesthesia ranged from 8 to 9 hours. The awakening time from the cessation of propofol infusion ranged from 3 to 17 minutes. As the result of this study, we came to the conclusion that propofol is an ideal intravenous anesthetic for brain surgery for epilepsy treatment.

Brain Surgery for Epilepsy under Propofol I.V. Anesthesia / 대한마취과학회지

The treatment for epilepsy has been studied throughout the course of human history. However, radical treatment of epilepsy has only been discovered recently with introduction of surgical treatment until now, palliative drug administration was common practice. During the anesthetic procedure for epilepsy surgery it is necessary for the patient to be alert and to cooperate with the surgeon while mapping and subcutaneous EEG test are carried out during the surgery. For this type of procedure, a new I.V. anesthetic, propofol is considered to be an ideal anesthetic agent because propofol is a short-acting and clear headed I.V. anesthetic agent for induction as the well as the maintenance of genenral anesthesia. In this study, only propofol was administered intravenously in 20 randomiied patients scheduled for brain surgery for epilepsy treatment. The mean infusion rate was 100 mcg/kg/min to maintain a satisfactory anesthesia. For the induction of anesthesia, slightly higher doses were required. The cardiovascular effects of propofol infusion was associated with slightly decrease of systolic, diastolic and mean arterial pressures. Arterial blood gases were analyzed for the evaluation of ventilatory function. PaCO2 were 41+/-4.23 mmHg preoperatively, 44+/-5.28 mmHg 30 min. following sedation, 42+/-6.35 mmHg 30 min. following awakening, 46+/-6.37 mmHg 30 min. following resedation, 44+/-4.79 mmHg at 2 hours and 44+/-6.51 mmHg at 4 hours after resedation and 36+/-3.98 mmHg 30 min. following recovery. PaO2 were 101+/-31.3 mmHg preoperatively, 190+/-47.13 mmHg 30 min. following sedation, 195+/-32 mmHg 30 min. following awakening, 209+/-29.23 mmHg 30 min. and 210+/-34.55 mmHg at 2 hours and 190+/-37.36 mmHg 4 hours following resedation, and 10.2+/-31.36 mmHg 30 min. following. PH were 7.38 preoperatively, 7.34+/-0.04 following sedation, 7.34+/-0.03 30 min. following awakening, 7.34+/-0.03 at 30 min. following resedation, 7.35+/-0.03 at 2 hours and 7.36+/-0.03 at 4 hours following resedation, and 7.38+/-3.98 at 30 min. after recovery. The duration of anesthesia was 8.5-12 hours. The duration of propofol anesthesia ranged from 8 to 9 hours. The awakening time from the cessation of propofol infusion ranged from 3 to 17 minutes. As the result of this study, we came to the conclusion that propofol is an ideal intravenous anesthetic for brain surgery for epilepsy treatment.