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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 614-619
DOI: 10.4103/ajns.AJNS_348_19
Original Article

Comparison of propofol and sevoflurane on cerebral oxygenation using juglar venous oximetery (SjVo2) in patients undergoing surgery for traumatic brain injury

Rajeev Chauhan
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Nidhi Panda
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Hemant Bhagat
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Neerja Bharti
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Ankur Luthra
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Shiv Soni
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Narender Kaloria
1   Department of Anesthesia and Intensive Care, AIIMS, Jodhpur, Rajasthan
,
Praveen Salunke
2   Department of Neurosurgery, PGIMER, Chandigarh
,
Vishwanath Bhaire
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
,
Summit Bloria
Department of Anesthesia and Intensive Care, PGIMER, Chandigarh
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Background: Traumatic brain injury (TBI) induces major insult to the normal cerebral physiology. The anesthetic agents may infrequently produce deleterious effects and further aggravate damage to the injured brain. This study was conducted to evaluate the effects of propofol and sevoflurane on cerebral oxygenation, brain relaxation, systemic hemodynamic parameters and levels of interleukin-6 (IL-6) in patients with severe TBI undergoing decompressive craniectomy. Methods: A prospective randomized comparative study was conducted on 42 patients undergoing surgery for severe TBI. Patients were randomized into two groups, Group P received propofol and Group S received sevoflurane for maintenance of anesthesia. All patients were induced with fentanyl, propofol, and vecuronium. The effect of these agents on cerebral oxygenation was assessed by jugular venous oxygen saturation (SjVO2). Hemodynamic changes and quality of intraoperative brain relaxation were also assessed. The serum levels of IL-6 were quantitated using enzyme-linked immunosorbent assay technique. Results: SjVO2 values were comparable and mean arterial pressure (MAP) was found to be significantly lower in Group P as compared to those in Group S (P < 0.05). Brain relaxation scores were comparable between the groups. The level of IL-6 decreased significantly at the end of surgery compared to baseline in patients receiving sevoflurane (P = 0.040). Conclusions: Cerebral oxygenation measured by SjVO2 was comparable when anesthesia was maintained with propofol or sevoflurane. However, significant reduction in MAP by propofol needs attention in patients with severe TBI. The decrease in IL-6 level reflects anti-inflammatory effect and probable neuroprotective potential of propofol and sevoflurane.

Key-words:

Jugular venous oxygenation - propofol - traumatic brain injury

Financial support and sponsorship

This study was supported by PGIMER, Chandigarh.




Publication History

Received: 01 December 2019

Accepted: 11 March 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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