Desflurane and target-controlled propofol for craniotomy: A randomized trial

Abstract

Selecting the optimal anaesthetic technique for craniotomy remains challenging because desflurane and target-controlled infusion (TCI) propofol differ in cerebral and recovery effects. Sixty ASA I-III patients undergoing elective supratentorial craniotomy were randomized to desflurane or TCI propofol and brain relaxation, haemodynamics, emergence and recovery were compared. Brain relaxation and intraoperative haemodynamic stability were similar, but desflurane produced faster extubation, eye opening and vocalization (all P<0.001). Desflurane was associated with higher post-operative pain and PONV, whereas blood loss was greater with TCI propofol (573 vs 440 mL, P<0.001). Thus, both techniques are suitable for elective craniotomy, with desflurane enabling faster emergence and TCI propofol improving post-operative comfort despite slower recovery.