[Use of propofol in intracranial surgery in 83 consecutive patients]

Propofol is an intravenous anesthetic agent with a short half-life allowing rapid recovery; it has cerebral hemodynamic effects similar to those of thiopental. The aim of the present study was to describe 83 patients (mean age 50.6 +/- 15.1 yrs) scheduled for intracranial surgery in whom a total intravenous anesthesia technique (TIVA) with propofol was used. 16 patients were operated in the sitting position. Mean propofol induction dose was 2.1 +/- 0.8 mg/kg combined with 2.3 +/- 1.8 micrograms/kg of fentanyl, 1.5 mg/kg of lidocaine, and 0.08 mg/kg of vecuronium to facilitate intubation. Before installation of the Mayfied pin-head holder, the site of the pins was infiltrated with 2-3 cc of lidocaine 1%. Anaesthesia was maintained with propofol 5.9 +/- 2.1 mg/kg/h and fentanyl 1.6 +/- 0.65 micrograms/kg/h. Mean values of mean arterial pressure and heart rate showed less than 10% variation at intubation, application of the pin-head holder and skin incision. Intracranial pressure measured by the lumbar route (after checking the patency of the CSF passage from the cerebral to the spinal compartments) varied by slightly more than 10%, starting at 11.3 +/- 6.0 mmHg before induction and 11.3 +/- 5.2 mmHg at intubation down to 9.5 +/- 4.5 mmHg after skin incision. The lumbar drainage in place allowed the surgeon to improve brain relaxation by drawing 5-20 cc of lumbar CSF. Duration of anaesthesia was 367 +/- 96 mn from induction to extubation.(ABSTRACT TRUNCATED AT 250 WORDS)