Anesthesia for Brain Tumor Surgery: A Comparative Review of Target-Controlled Infusion Propofol with and without Dexmedetomidine
DOI:
https://doi.org/10.52783/jns.v14.3221Keywords:
Target-Controlled Infusion, Propofol, Dexmedetomidine, Brain Tumor Surgery, Neuroanesthesia.Abstract
Brain tumor surgeries pose significant challenges due to high morbidity and mortality rates, often resulting in extended intensive care unit stays and complications from neuroinflammation, such as postoperative cognitive dysfunction. This review compares the efficacy of two anesthesia techniques: target-controlled infusion propofol combined with dexmedetomidine versus propofol alone. It explores the impact of these approaches on immediate and long-term patient outcomes, focusing on inflammatory markers, cognitive function, cost-effectiveness, and the risk of propofol-related infusion syndrome. Total intravenous anesthesia with target-controlled infusion of propofol is preferred for its effectiveness in facilitating faster neurological recovery, reducing neuroinflammatory markers like interleukin-6 and S100B, promoting brain relaxation, and lowering intracranial pressure while preserving cognitive function. Although propofol is effective as a single hypnotic agent when used with opioids and muscle relaxants, there is increasing interest in dexmedetomidine as an adjunct. The combination of dexmedetomidine with propofol may enhance neuroprotection, further reduce inflammation, and lower the incidence of postoperative cognitive dysfunction while providing anesthetic-sparing effects that can reduce costs. Using dexmedetomidine can also mitigate the risk of propofol-related infusion syndrome by lowering propofol consumption, thus reducing the likelihood of lactic acidosis during lengthy surgeries. While initial medication costs may increase with dexmedetomidine, it could lead to long-term savings by minimizing complications and intensive care unit stays. The choice between propofol alone or in combination with dexmedetomidine should be tailored to individual patient needs and institutional resources. Further research is needed to understand the long-term outcomes and economic implications of this combination in brain tumor surgeries.
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