RESUMEN
BACKGROUND: When we use a volatile anesthetic that increases cerebral blood flow (CBF) and propofol which decreases CBF in appropriate doses, respectively, an increase in ICP and cerebral ischemia can be prevented. The purpose of this study was to look for the proper method for balanced anesthesia using a jugular bulb oxygen saturation (SjO2) that depends on the concentration of propofol used in combination with isoflurane-N2O anesthesia. METHODS: Randomly we divided these patients into group 1 (12 patients), group 2 (12 patients), and group 3 (15 patients). Using a Master TCI and injecting a volatile anesthetic continuously, we injected 2ng/ml of blood concentration to group 1, 3ng/ml to group 2 and 4ng/ml to group 3 and maintained a partial pressure of CO2 in the vein around 30 mmHg during the operation. After induction of anesthesia, injection of propofol, and the dura mater was opened, we measured mean arterial blood pressure, heart rate, respectively, measured partial pressure of CO2, hematocrit, oxygen saturation sampling the arterial blood, measured oxygen saturation sampling jugular bulb. RESULTS: There were no differences of mean arterial blood pressure, heart rate, hematocrit, arterial blood partial pressure of CO2, oxygen saturation, or jugular bulb oxygen saturation among the groups. In addition, there were no statistical differences of variables measured before and after injecting propofol and the dura was opened. For 1 in group 1, 2 in group 2, and 3 in group 3, jugular oxygen saturation dropped below 50% after injecting propofol, but was not verified statistically. CONCLUSIONS: There were no significant hemodynamic effects when we used propofol with the volatile anesthetic in neuroanesthetic management.