간질수술에서 Propofol 정맥마취의 이용

Abstract

Background: Propofol is a new, short-acting intravenous sedative-hypnotic anesthetics for induction and maintenance. Awakening craniotomy for resection of seizure focus is performed when the area to be excited is too close to an eloquent area to be mapping accurately. This study was performed to evaluate the efficacy and the hemodynamic effects of Pofol® in comparison with Diprivan® for the maintenance of total intravenous anesthesia (TIVA) in epilepsy surgery. Methods: This procedure is carried out under what has been euphemistically called local anesthesia or monitored anesthesia care (MAC). For induction, 2 mg/kg in bolus was administered in both groups, and the usual maintaining dose was 100 mcg/kg/min. Surgical procedures are divided in 6 stage (I: Craniotomy, II: Electrocorticography (ECoG), III: Functional mapping, IV: Cortical resection, V: Post-resection EEG, VI: Craniotomy closure). Results: Arterial blood gases and vital signs of Pofol® group and Diprivan® group were analysed. But, awakening time was slightly rapid in Pofol® group (8.9 2.64 min.) compared with Diprivan® group (10.6 3.22 min.). And there were no statistically significant differences between the two groups. Conclusions: We concluded that both Pofol® and Diprivan® are the ideal total intravenous anesthetics for long time epilepsy surgery. However, Pofol® group is more helpful in intraoperative ECoG and functional brain mapping because of its slightly rapid awakening time. (Korean J Anesthesiol 1998; 35: 70∼75)