Résumé
BACKGROUND: Stereotactic thalamotomy and pallidotomy for Parkinson's disease or essential tremor have been performed under local anesthesia. But some neurosurgeons have been reluctant to utilize this technique because of patient discomfort and neurological complications. So we used the propofol that provides excellent sedation and rapid and smooth recovery of mental abilities with minimal side effects. METHODS: After the patients were placed into the Leksell's stereotactic frame, anesthesia was induced by continuous infusion of propofol at the rate of 150 mcg/kg/min and then maintained at the rate of 50 mcg/kg/min. We investigated the hemodynamic changes, ABGA, total dose of propofol, time to loss of consciousness, recovery time from the end of infusion to eyes opening and side effects. RESULTS: The blood pressure decreased significantly at infusion start 15 min and 30 min (p<0.05) and heart rate decreased significantly at infusion start 30 min (p<0.05). The PaCO2 increased significantly at infusion start 15 min and 30 min (p<0.05). Total dose of propofol was 202.4+/-59.8 mg, time to loss of consciousness was 13.0+/-4.4 min, recovery time was 9.0+/-4.7 min and side effects were pain on infusion (2 cases) and postoperative nausea (1 case). CONCLUSIONS: Stereotactic thalamotomy and pallidotomy for Parkinson's disease or essential tremor were performed by infusion of propofol with minimal side effects and no neurological complications.