Propofol vs. sevoflurane as anaesthetic maintenance agents in patients undergoing brain aneurysm coiling – randomized prospective study

Summary

Background:
Sevoflurane and propofol are commonly used anaesthetic agents for general anaesthesia. It has not been established which of them is more suitable for maintaining general anaesthesia during brain aneurysm treatment with endovascular coiling.

Objective:
We studied an effect of two anaesthetic maintenance agents on perioperative hemodynamic stability and the rate of complications in patients undergoing brain aneurysm coiling.

Design:
Prospective randomised trial.

Setting:
The tertiary level university hospital.

Patients:
110 patients with brain aneurysms treated by endovascular coiling under general anaesthesia.

Interventions:
Patients were randomised into 2 groups. The first group (S, 55 patients) received sevoflurane, the second group (P, 55 patients) received propofol infusion to maintain general anaesthesia. Induction into anaesthetic was the same in both groups.

Measurements and Main Results:
Group S patients were significantly more hemodynamically stable in the term of mean arterial pressure (p = 0.001). Recovery time was shorter in S group. Perioperative bradycardia occurred in the Group P more often (P = 0.039) meanwhile hypertension was more frequent in the Group S (P = 0.001).

Conclusions:
Our results suggest that sevoflurane can be better choice than propofol infusion for patients with brain aneurysms treated by endovascular coiling under general anaesthesia.

Key words:
brain aneurysm – coiling – general anaesthesia – sevoflurane – propofol