Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies
ABSTRACTBackground In neurosurgical procedures, selection of anesthetic techniques can have a substantial role in neurological outcome. Ischemia modified albumin (IMA) is a promising biomarker in strokes either hemorrhagic or ischemic. This work tried to explore the impact of type of the used anesth...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
|
| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2154011 |
| _version_ | 1797959119459581952 |
|---|---|
| author | Omyma Shehata Mohamed Mohab Mohamad Darwish Mahmoud Mohamed Mousa Abd Elrahman Hassan Abd Elaziz Ahmed Korani Mohamed |
| author_facet | Omyma Shehata Mohamed Mohab Mohamad Darwish Mahmoud Mohamed Mousa Abd Elrahman Hassan Abd Elaziz Ahmed Korani Mohamed |
| author_sort | Omyma Shehata Mohamed |
| collection | DOAJ |
| description | ABSTRACTBackground In neurosurgical procedures, selection of anesthetic techniques can have a substantial role in neurological outcome. Ischemia modified albumin (IMA) is a promising biomarker in strokes either hemorrhagic or ischemic. This work tried to explore the impact of type of the used anesthetics on operative condition, outcome, and if it can affect the level of IMA after emergency craniotomies.Methodology Fifty-four patients, 18–69 years of either sex, GCS>8, who underwent emergency craniotomies were enrolled into two groups where anesthesia was maintained by either: isoflurane ≤ 1Mac + fentanyl 1 mcg/kg/h. (Group I (inhalational)) or propofol infusion (100–150 mcg/kg/min) + dexmedetomedine 0.3mcg/kg/h. (Group P (TIVA)). Intraoperative hemodynamics, ICP, brain relaxation score, blood loose, and surgeon satisfaction were assessed. Also, recovery conditions, ICU stay, any complication and mortality, pre- and postoperative IMA and GCS were followed and analyzed.Results Group (P) revealed lower but steadier hemodynamics, significantly better brain relaxation score, lower ICP, adequate CPP, fewer patients needed blood transfusion, better surgeon satisfaction, and significantly shorter extubation time with higher sedation. Elevation in postoperative IMA was reported in both groups but the times of increase were significantly lower in group (P) with significant correlation between IMA level and GCS at all times that were detected in both groups. The two groups were comparable regarding postoperative complications, GCS, mortality, and ICU stay.Conclusion In emergency craniotomies, the use of TIVA (propofol + dexometomidine) produced lower ICP, better brain relaxation, and shorter extubation time with lower postoperative IMA level than inhalational anesthetics, which correlate well with GCS. |
| first_indexed | 2024-04-11T00:29:14Z |
| format | Article |
| id | doaj.art-2b642cc8bf6e4dc5b8d07bccb1eddf35 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-11T00:29:14Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-2b642cc8bf6e4dc5b8d07bccb1eddf352023-01-08T05:07:41ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139111010.1080/11101849.2022.2154011Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomiesOmyma Shehata Mohamed0Mohab Mohamad Darwish1Mahmoud Mohamed Mousa2Abd Elrahman Hassan Abd Elaziz3Ahmed Korani Mohamed4Minia university hospital, Faculty of medicine, Minia university, Minia, EgyptNeurosurgery, Minia university hospital, Faculty of medicine, Minia university, Minia, EgyptFaculty of Medicine Minia University, Minia University Hospital, Minia, EgyptMinia university hospital, Faculty of medicine, Minia university, Minia, EgyptMinia university hospital, Faculty of medicine, Minia university, Minia, EgyptABSTRACTBackground In neurosurgical procedures, selection of anesthetic techniques can have a substantial role in neurological outcome. Ischemia modified albumin (IMA) is a promising biomarker in strokes either hemorrhagic or ischemic. This work tried to explore the impact of type of the used anesthetics on operative condition, outcome, and if it can affect the level of IMA after emergency craniotomies.Methodology Fifty-four patients, 18–69 years of either sex, GCS>8, who underwent emergency craniotomies were enrolled into two groups where anesthesia was maintained by either: isoflurane ≤ 1Mac + fentanyl 1 mcg/kg/h. (Group I (inhalational)) or propofol infusion (100–150 mcg/kg/min) + dexmedetomedine 0.3mcg/kg/h. (Group P (TIVA)). Intraoperative hemodynamics, ICP, brain relaxation score, blood loose, and surgeon satisfaction were assessed. Also, recovery conditions, ICU stay, any complication and mortality, pre- and postoperative IMA and GCS were followed and analyzed.Results Group (P) revealed lower but steadier hemodynamics, significantly better brain relaxation score, lower ICP, adequate CPP, fewer patients needed blood transfusion, better surgeon satisfaction, and significantly shorter extubation time with higher sedation. Elevation in postoperative IMA was reported in both groups but the times of increase were significantly lower in group (P) with significant correlation between IMA level and GCS at all times that were detected in both groups. The two groups were comparable regarding postoperative complications, GCS, mortality, and ICU stay.Conclusion In emergency craniotomies, the use of TIVA (propofol + dexometomidine) produced lower ICP, better brain relaxation, and shorter extubation time with lower postoperative IMA level than inhalational anesthetics, which correlate well with GCS.https://www.tandfonline.com/doi/10.1080/11101849.2022.2154011Emergency craniotomiesTIVAinhalational agentsIMA |
| spellingShingle | Omyma Shehata Mohamed Mohab Mohamad Darwish Mahmoud Mohamed Mousa Abd Elrahman Hassan Abd Elaziz Ahmed Korani Mohamed Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies Egyptian Journal of Anaesthesia Emergency craniotomies TIVA inhalational agents IMA |
| title | Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies |
| title_full | Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies |
| title_fullStr | Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies |
| title_full_unstemmed | Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies |
| title_short | Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies |
| title_sort | impact of mode of anesthesia on ischemia modified albumin operative conditions and outcome in emergency craniotomies |
| topic | Emergency craniotomies TIVA inhalational agents IMA |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2154011 |
| work_keys_str_mv | AT omymashehatamohamed impactofmodeofanesthesiaonischemiamodifiedalbuminoperativeconditionsandoutcomeinemergencycraniotomies AT mohabmohamaddarwish impactofmodeofanesthesiaonischemiamodifiedalbuminoperativeconditionsandoutcomeinemergencycraniotomies AT mahmoudmohamedmousa impactofmodeofanesthesiaonischemiamodifiedalbuminoperativeconditionsandoutcomeinemergencycraniotomies AT abdelrahmanhassanabdelaziz impactofmodeofanesthesiaonischemiamodifiedalbuminoperativeconditionsandoutcomeinemergencycraniotomies AT ahmedkoranimohamed impactofmodeofanesthesiaonischemiamodifiedalbuminoperativeconditionsandoutcomeinemergencycraniotomies |