Effects of Total Intravenous Anaesthesia with Propofol in Patients Undergoing Burr Hole Drainage for Chronic Subdural Haematoma: A Prospective, Randomized, Controlled Clinical Trial

Abstract

Background: Burr hole drainage for chronic subdural haematoma is a common neurosurgical treatment. Traditionally which were done under local anaesthesia with sedation. The primary aim of this prospective study was to assess the effects of Total intravenous anaesthesia with Propofol forBurr hole drainage of chronic subdural haematoma.

Method: Sixty adults patients age group ranging from 20-80 years without gender discrimination scheduled for Burr hole drainage of chronic subdural haematoma were enrolled in this study. The patients were randomized into two groups. Group A received Inj. propofol I/V @ 1mg/kg over 10 min followed by 25-50 ìg/kg/ min infusion. Group B received Inj. Midazolam0.05mg/kg I/V followed by normal saline infusion at 0.2 ml/ kg/hr infusion. Perioperative GCS Score, Heart Rate (HR), mean arterial pressure (MAP), SpO2, Ramsay sedation score (RSS), complications, rescue drugs requirements are recorded and compared at specific time.

Results: The MAP and HR was monitored throughout the perioperative period in both groups and they were more in Group B than Group A in most time intervals and was statistically significant. The Ramsay sedation score (RSS) was significantly lower in Group B patients when compared with Group A.Perioperative requirements of rescue drugs and complications like nausea, vomiting (11.7%) and shivering (13.3%) consecutively were more in group B than in group A and it was statistically significant.

Conclusion: This study suggests that Total intravenous anaesthesia with propofol is safe & effective technique alone for Burr hole drainage of CSDH than local anaesthesia with sedation. It also facilitates patient comfort and surgical competence during surgery, perioperative haemodynamicstability,less perioperative complications, thus reduced hospital stay.

Bang. J Neurosurgery 2019; 8(2): 100-104