Propofol sedation during awake craniotomy for seizures: Patient- controlled administration versus neurolept analgesia

Ian A. Herrick*, Rosemary A. Craen, Adrian W. Gelb, Laurie A. Miller, Cynthia S. Kubu, John P. Girvin, Andrew G. Parrent, Michael Eliasziw, Joyce Kirkby

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

83 Citations (Scopus)

Abstract

This prospective study evaluated the safety and efficacy of patient- controlled sedation (PCS) using propofol during awake seizure surgery performed tinder bupivacaine scalp blocks. Thirty-seven patients were randomized to receive either propofol PCS combined with a basal infusion of propofol (n = 20) or neurolept analgesia using an initial bolus dose of fentanyl and droperidol followed by a fentanyl infusion (n = 17). Both groups received supplemental fentanyl and dimenhydrinate for intraoperative pain and nausea, respectively. Comparisons were made between groups for sedation, memory, and cognitive function, patient satisfaction, and incidence of complications. Levels of intraoperative sedation and patient satisfaction were similar between groups. Memory and cognitive function were well preserved in both groups. The incidence of transient episodes of ventilatory rate depression (<8 bpm) was more frequent among the propofol patients (5 vs 0, P = 0.04), particularly after supplemental doses of opioid. Intraoperative seizures were more common among the neurolept patients (7 vs 0, P = 0.002). PCS using propofol represents an effective alternative to neurolept analgesia during awake seizure surgery performed in a monitored care environment.

Original languageEnglish
Pages (from-to)1285-1291
Number of pages7
JournalAnesthesia and Analgesia
Volume84
Issue number6
DOIs
Publication statusPublished - 1997
Externally publishedYes

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