Propofol versus remifentanil patient controlled sedation for awake craniotomy during epileptic surgeries

ABSTRACT

Anaesthesia for neurosurgical procedures, specificaity craniotomies requiring patient participation presents a challenge to both the neuroanaesthesiologist and the neurosurgeon Despite the popularity of general anaesthesia for these procedures, there has been a renewed interest in this technique of awake craniotomy due to its definite advantages m specific patient populations. This study evaluate two anaesthetic regimens for propofoi and remifentanil for awake craniotomy in epileptic surgeries. Total drug administered, incidence of complications, sedation score and patient satisfaction were assessed in 20 patients, randomely assigned into 2 equal groups, aged 18-55 years undergoing awake craniotomy for epileptic surgeries. Sedation was induced vis propofol patient controlled sedation in group I and via remifentanil patient controlled sedation in group II. five patients in the remifentanil group versus two patients in propofol group experienced nausea and /or vomiting. Respiratory rate depression, desturation were more frequent in remifentanil group while pain and hypotension were more frequent in propofoi group Both groups achieved a good level of sedation and patient satisfaction. Propofol and remifentanil are almost ideal drugs for conscious sedation during avjake craniotomy