ORIGINAL ARTICLE

Comparison of hemodynamic response between propofol and thiopental as an induction agent in neurosurgery anesthesia at Haji Adam Malik General Hospital Medan-Indonesa

Cwanestasia Zefanya Gracia , Achsanuddin Hanafie, Akhyar H Nasution

Cwanestasia Zefanya Gracia
Pre-graduate in Anesthesiology, Faculty of Medicine Universitas Sumatera Utara, Medan-Indonesia. Email: [email protected]

Achsanuddin Hanafie
Departement of Anesthesiology, Intensive Care Division, Haji Adam Malik General Hospital, Medan-Indonesia.

Akhyar H Nasution
Departement of Anesthesiology, Cardiovascular Anesthesia Division, Haji Adam Malik General Hospital, Medan-Indonesia.
Online First: October 03, 2018 | Cite this Article
Gracia, C., Hanafie, A., Nasution, A. 2018. Comparison of hemodynamic response between propofol and thiopental as an induction agent in neurosurgery anesthesia at Haji Adam Malik General Hospital Medan-Indonesa. Bali Medical Journal 7(3). DOI:10.15562/bmj.v7i3.1046


Introduction: The neuro anesthesia technique is the only anesthetic technique used today in craniotomy surgery, the anesthetic doctor must pay attention to the components of CBF and ICP which depends on the hemodynamic parameters of patient. Such condition is influenced by anesthetic drugs used in the technique. Intravenous anesthetic drugs that can decrease ICP and CBF from induction drug classes are thiopental, propofol, etomidate, and midazolam. Aim of this study is to obtain comparison of hemodynamic response after administration of propofol and thiopental as an induction drug in brain surgery with general anesthesia.Methods: Study design using double-blinded randomized clinical trial with a total sample of 40 research subjects performed elective brain surgery using general anesthesia techniques. The sample was divided into two groups, the patients were induced with propofol 2 mg /kg for group A and thiopental 4.5 mg /kg for group B in 1 minute. Measurements of hemodynamic response (systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure and RPP score) were tested. The results were tested using independent sample t-test, with a significance level of 95% (p <0.05).Results: The results showed that mean systolic blood pressure, diastolic blood pressure, mean arterial pressure and RPP score between group A and B was significantly different from T1, T2, T3 (p <0,05). Meanwhile, for heart rate, there were no significant differences (p > 0.05).Conclusions: There were significant hemodynamic differences in the administration of thiopental and propofol drugs in brain surgery patients. Thiopental drug administration showed lower systolic blood pressure, diastolic blood pressure and mean arterial pressure compared to propofol for induction drugs.

References

Barcena, Jon Perez, et.al. Pentobarbital Versus Thiopental in The treatment of refractory intracranial hypertension in patients with traumatic b raiinjury : a randomized controlled trial. BiomedCentral. 2008 : 1-26

Daniel, S thiopental Sodium in Ambulatory Anesthesia.2005. Germany: Rotexmedica GmbH n

Mikkelsen, Mai Loise, et.al. The Effect of Dexmedetomidine of cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia. 2016. BiomedCentral : 1-15

Prabhakar, Hemanshu. Propofol versus Thiopental Sodium for The Treatment of Refractory Status Epilepticus. 2012. The Cochrane Collaboration : 1488-1508

Yazici, Esra. Comparing ECT data of two different inpatient clinics: Propofol or Thiopental. 2013. Int J Psychiatry ClinPract : 307-312

Madhusana, Aswathappa, Simha, Gundappa, Iyer. A comparative Study of Intra operative Brain Relaxation with Thiopentone, &Propofol for Supratentorial Tumor Surgery,2014. IOSR Journal of Dental and Medical Science.

Winarno I, Listyanto J, Harahap MS. Pengelolaan Trauma SusunanSarafPusat, 2010. BagianAnestesiologidanTerapiIntensif FK UNDIP/ RSUP Dr. Kariadi, Semarang.

Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental Sodium for the treatment of refractory statua epilepticus (Review), 2013. Evid Based Child health 8:4 : 1488 – 1508.

Warner, S. Anesthesia for craniotomy. 2002. Department of Anesthesiology, Duke University Medical Centre, Durham, North Caroline, USA 27710.

Morgan GE, Mikhail MS, Murray MJ. Perioperative pain managament&enhanched outcomes. In: Clinical anesthesiology, 5th ed. Lange Medical Books/McGraw-Hill, 2013: 1087-105.

Stoelting RK, Hillier SC. Pain. In: Pharmacology &physiology in anesthetic practice, 4th ed. Lippincott Williams & Wilkins, 2006: 707-17.

Bisri T. PenangananNeuroanestesiadan critical care CederaOtakTraumatik. FakultasKedokteranUnivesitasPadjajaran, 2012.

Newfield P, Cottrell JE,. Handbook of Neuroanesthesia. Lippincott Williams & Wilkins, 2012 : 87-90.

ROZEK B, Flooch H, Berlivet P, Michel P., Blanloeil Y. Propofol Versus Thiopental by target controlled infusion in patients undergoing craniotomy. Hopital, de La Cavale,Blanche, Cebter Hospital- Universitaire, Brest, France, 2014;80:761-8

Traill R, Acute Head Injuries :Anaesthetic Consideration. Department of Anesthesia, Royal prince Alfred Hospital, Sydney.2007.

Patel P. Neurosurgical Anesthesia, Does the choice of anaesthetic agents matter?. Department of Anaesthesia University of California, San diago.2007.

Bozic JM, Karpe B, Potocnik I, Jerin A, Vranic A and Jankocic VN. Effects of Propofol and Sevoflurane on the inflammatory response of patients undergoing craniotomy. Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, Ljubljana, SI-1000 Slovenia, 2015.

Sembulingam, Prema, Ilango, Saraswathi, G, Sridevi. Rate Pressure Product as a Determinant of Physical Fitness in Normal Young Adult. Internasional of Dental and Medical Sciences journal volume 14, Issue 4 Ver.II, 2015.

Lestari,A.P.PerbedaanPengaruhPemberianPropofoldanTiopentalTerhadapResponHemodinamikPadaInduksiAnestesi Umum,2010. BagianAnestesiologidanTerapiIntensif FK UNDIP/ RSUP Dr. Kariadi, Semarang.

Said A Latif, Kartini A Suryadi M RuswanDachlan. PetunjukPraktisAnestesiologi. ed 2. BagianAnestesiologi Dan TerapiIntensif FK UI. Jakarta, 2007 ; 9 – 33. 4.

Cole CD dkk. Total Intravenous Anesthesia: advantages ForIntakranial Surgery Neurosurgery 2007; 61:369-278.

Hill L, Gwinnutt C. Cerebral Blood Flow AndIntraticranialPreassure 2007

Bruder N, Ravussin PA. Supratentorial masses: Anesthetic Considerations. Dalam: Cottrell and Young’s NEUROANESTHESIA 5thed; Philadelpia: Moby Ersevier, Inc: 2010, 188-96

Joshi S, Yadau R, Malla G. Initial Experience with Total Intravenous Anesthesia with Proposal for Elective Craniotomi, Nepal Journal of Neuroscience 2007; 4;67-9

Kanonidou Z, Karystianou G, Anesthesia for the elderly. Hipokratia 2007,11 (4): 175-177

Dagal A, Lam A: Cerebral Blood Flow and The Injured Brain: How Should We Monitoring and Manipulate it? CurrOpinAnesthesiol 2011;24;131

Grocott H, Davie S, Fedorow C: Monitoring of Brain Function in Anesthesia and Intensive Care.CurrOpinAnesthesiol 2010; 23; 759

Michael A Figueroa, Ronald E DeMeersman,1 and James Manning. The Autonomic and Rate Pressure Product Responses of Tai Chi Practitioners. N Am J Med Sci. 2012 June; 4 (6): 270–275.)

PremaSembulingam, Sembulingam K, Glad Mohesh. Gender differences in body mass index and blood pressure among normal healthy undergraduate students. Int J Med Res Health Sci. 2013;2(3):527-532)

http://www.ncsf.org/ 2.8.2012: 8.45 AM. Understanding Exercise Intensity and Rate Pressure Product (RPP) By NCSF on: Feb 17 2011)

Uzun, Ş., Özkaya, B. A., Yilbaş, Ö. S., Ayhan, B., Şahİn, A., &Aypar, Ü. (2011). Eff ects of diff erentpropofol injection speeds on blood pressure , dose , and time of induction. Turk J Med Sci, 41(3), 397–401. https://doi.org/10.3906/sag-1001-534

Garcia, P., Kolesky, S., & Jenkins, A. (2010). General Anesthetic Actions on GABA Receptors. Current Neuropharmacology, 8(1), 2–9. https://doi.org/10.2174/157015910790909502

Barakat, A., Ghabbour, H. A., Al-Majid, A. M., Qurat-Ul-Ain, Imad, R., Javaid, K., … Wadood, A. (2016). Synthesis, X-Ray Crystal Structures, Biological Evaluation, and Molecular Docking Studies of a Series of Barbiturate Derivatives. Journal of Chemistry, 2016. https://doi.org/10.1155/2016/8517243

A.Y., F., A.D., K., R.J., K., K., B., & R.D., U. (2017). Novel propofol derivatives and implications for anesthesia practice. Journal of Anaesthesiology Clinical Pharmacology, 33(1), 9–15. https://doi.org/10.4103/0970-9185.202205

Gupta, S., Sharma, R., &Dimpel, J. (2005). Airway Assessment : Predictors of Difficult Airway. Indian Journal of Anaesthesia, 49(4), 257–262.

Berkow, L. C., &Ariyo, P. (2015). Preoperative assessment of the airway. Trends in Anaesthesia and Critical Care. https://doi.org/10.1016/j.tacc.2014.11.003

Bradley P, Chapman G, Crooke Ben (2016). Airway Assessment. Australian and New Zaeland College of Anesthetist.

Ansari, M., Javadi, H., Pourbehi, M., Mogharrabi, M., Rayzan, M., Semnani, S., … Assadi, M. (2012). The association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: A preliminary study. Perfusion, 27(3), 207–213. https://doi.org/10.1177/0267659112436631


Article Views      : 0
PDF Downloads : 0