| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website http://www.jocmr.org |
Review
Volume 7, Number 10, October 2015, pages 731-741
Effects of Anesthetic Management on Early Postoperative Recovery, Hemodynamics and Pain After Supratentorial Craniotomy
Tables
| Activity | |
| 2 | Able to move spontaneously or on command four extremities |
| 1 | Able to move voluntarily or on command two extremities |
| 0 | Unable to move any extremities |
| Respiration | |
| 2 | Able to deep breath and cough freely |
| 1 | Dyspnea, shallow or limited breathing |
| 0 | Apneic |
| Circulation | |
| 2 | BP + 20 mm Hg of pre-sedation level |
| 1 | BP + 20 - 50 mm Hg of pre-sedation level |
| 0 | BP + 50 mm Hg of pre-sedation level |
| Consciousness | |
| 2 | Fully awake |
| 1 | Arousable on calling |
| 0 | Not responding |
| Skin color | |
| 2 | Normal |
| 1 | Pale, dusky, blotchy, jaundiced, other |
| 0 | Cyanotic |
| Studies | Drugs | Clinical variables | Results |
|---|---|---|---|
| ET: extubation time; TEO: time to eyes opening; GCS: Glasgow coma scale; VAS: visual analogue scale; SOMCT: short orientation memory concentration test. | |||
| Lauta et al, 2010 [11] | Sevoflurne/remifentanil vs. propofol/remifentanil | Aldrete score TEO ET | No clinical differences |
| Ravussin et al, 1991 [24] | Thiopental/isoflurane vs. propofol | GSC | Propofol group had higher GSC score in early recovery |
| Todd et al, 1993 [12] | Propofol/fentanyl vs. isoflurane/nitrous oxide vs. fentanyl/nitrous oxide | ET Time to commands Aldrete score | No statistical difference |
| Talke et al, 2002 [13] | Propofol vs. isoflurane vs. propofol/isoflurane | ET TEO Aldrete score VAS | No statistical differences |
| Magni et al, 2005 [14] | Sevoflurane/fentanyl vs. propofol/remifentanil | ET SOMCT | No statistical differences |
| Citerio et al, 2012 [23] | Sevoflurane/fentanyl vs. sevoflurane/remifentanil vs. propofol/remifentanil | Aldrete score | No statistical difference |
| Bhagat et al, 2008 [16] | At time of dural closure bolus of propofol vs. fentanyl vs. isoflurane | Time to emergence (dressing completion to extubation) Early emergence (< 15 min) GCS | Propofol > isoflurane > fentanyl 6 min > 5 min > 4 min (P = 0.0008) - not clinically significant No statistical difference |
| Sneyd et al, 2005 [17] | Propofol/remifentanil vs. sevoflurane/remifentanil | ET TEO Obey commands | No clinical differences |
| Studies | Drugs | Clinical variables | Results |
|---|---|---|---|
| ET: extubation time; GCS: Glasgow coma scale; SOMCT: short orientation memory concentration test. | |||
| Guy et al, 1997 [10] | Remifentanil vs. fentanyl | ET Quality of recovery | No statistical difference Low recovery score within 60 min more in fentanyl group Naloxone use more in fentanyl group |
| Citerio et al, 2012 [23] | Sevoflurane/remifentanil vs. sevoflurane/fentanyl vs. propofol/remifentanil | Aldrete score | No statistical difference |
| Gerlach et al, 2003 [18] | Remifentanil/propofol vs. sufentanil IV pushes/propofol | ET | Remifentanil group had earlier ET 6.4 min vs. 14.3 min (P = 0.003) |
| Balakrishnan et al, 2000 [19] | Remifentanil vs. fentanyl | ET (P = 0.04) Obay commands (P < 0.001) ET (P = 0.04) Recovery in 10 min (P = 0.005) Recovery in 20 min | Better in remifentanil group No statistical difference |
| Van der Zwan et al, 2005 [22] | Remifentanil/piritramide vs. fentanyl | GCS Aldrete score | No statistical difference |
| Del Gaudio et al, 2006 [7] | Remifentanil vs. fentanyl | ET Obey commands Orientationx3 Aldrete score | Remifentanil group faster (P < 0.001) |
| Djian et al, 2006 [20] | Remifentanil vs. sufentanil | ET | No statistical difference |
| Bilotta et al, 2007 [21] | Remifentanil vs. sufentanil | ET SOMCT | No statistical difference Higher in remifentanil group (P < 0.0001) |
| From et al, 1990 [30] | Alfentanil vs. fentanyl vs. sufentanil | Alertness | More in alfentanil group |
| Studies | Drugs | Clinical variable | Results |
|---|---|---|---|
| Lauta et al, 2010 [11] | Sevoflurane/remifentanil vs. propofol/remifentanil | HR MAP | No statistical difference Sevo/Remi - more hypotension episodes (P = 0.0167) |
| Ravussin et al, 1991 [24] | Thiopental/isoflurane vs. propofol | HR, MAP CPP | No statistical difference Lower in propofol group |
| Todd et al, 1993 [12] | Propofol/fentanyl vs. isoflurane/nitrous oxide vs. fentanyl/nitrous oxide | ICP MAP HR | Iso/N2O - higher ICP, HR, lower MAP The difference is not statistically significant |
| Guy et al, 1997 [10] | Remifentanil vs. fentanyl | SBP ICP, CPP | Higher in fentanyl group P = 0.004 No statistical difference |
| Talke et al, 2002 [13] | Propofol vs. isoflurane vs. propofol/isoflurane | BP, HR | No statistical difference |
| Magni et al, 2005 [14] | Sevoflurane/fentanyl vs. propofol/remifentanil | MAP: intraoperative hypotension; postoperative HTN HR | Remifentanil group had more hypotension intraoperative (P = 0.002), hypertension postoperative (P = 0.0046) No statistical difference |
| Bhagat et al, 2008 [16] | Propofol vs. fentanyl vs. isoflurane | Less esmolol use with fentanyl P = 0.001 | |
| Sneyd et al, 2005 [17] | Remifentanil/propofol vs. remifentanil/sevoflurane | MAP | Remi/Sevo - more hypotension episodes (P = 0.053) |
| Balakrishnan et al, 2000 [19] | Remifentanil vs. fentanyl | HR, MAP | No statistical difference |
| Del Gaudio et al, 2006 [7] | Remifentanil vs. fentanyl | HR, MAP | No statistical difference |
| Djian et al, 2006 [20] | Remifentanil vs. sufentanil | MAP HR | Remifentanil P = 0.037 better MAP, HR stability |
| From et al, 1990 [30] | Alfentanil vs. fentanyl vs. sufentanil | RR PH | Lower after extubation in Sufentanil group |
| Warner, 1996 [38] | Alfentanil vs. remifentanil | ICP MAP decrease | No statistical difference |
| Studies | Drugs | Clinical variable - pain |
|---|---|---|
| Lauta et al, 2010 [11] | Sevoflurane/remifentanil vs. propofol/remifentanil | No statistical difference |
| Guy et al, 1997 [10] | Remifentanil vs. fentanyl | No statistical difference |
| Talke et al, 2002 [13] | Propofol vs. isoflurane vs. propofol/isoflurane | No statistical difference |
| Gerlach et al, 2003 [18] | Remifentanil/propofol vs. sufentanil/propofol | No statistical difference |
| Van der Zwan et al, 2005 [22] | Remifentanil/piritramide vs. fentanyl | Remifentanil - more pain postoperatively Not statistically significant |
| Djian et al, 2006 [20] | Remifentanil vs. sufentanil | Remifentanil - greater use of morphine postoperatively (P = 0.016) |