Evidence map›Paper›PMID 39777171›Full record

ArticleSurgical neurology international2024

Comparison of dexmedetomidine versus fentanyl-based total intravenous anesthesia technique on the requirement of propofol, brain relaxation, intracranial pressure, neuronal injury, and hemodynamic parameters in patients with acute traumatic subdural hematoma undergoing emergency craniotomy: A randomized controlled trial.

Vivek Chandar Chinnarasan, Prasanna Udupi Bidkar, Srinivasan Swaminathan, Manoranjitha Mani, Balasubramaniyan Vairappan, Protiti Chatterjee, Jerry Jame Joy, Ankita Dey, Rajasekar Ramadurai, Adethen Gunasekaran

Registry-linked trialAbstract read
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In one paragraph

Article in Surgical neurology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07105618 (Comparison of Dexmedetomidine Versus Fentanyl or Magnesium Sulphate as Adjuncts to Propofol-Based Total Intravenous Anesthesia in Patients Undergoing Craniotomy), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07105618 naactive not recruitingnot on this mapstarted 2025, after this paper: background citation

Comparison of Dexmedetomidine Versus Fentanyl or Magnesium Sulphate as Adjuncts to Propofol-Based Total Intravenous Anesthesia in Patients Undergoing Craniotomy

TypeinterventionalSponsorZagazig UniversityRan2025 to 2027Enrolled120ConditionsAnesthesiaArmsDexmedetomidine, Fentanyl, Magnesium
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Vivek Chandar ChinnarasanDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Prasanna Udupi BidkarDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Srinivasan SwaminathanDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Manoranjitha ManiDepartment of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Balasubramaniyan VairappanDepartment of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Protiti ChatterjeeDepartment of Neuroanaesthesiology and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Jerry Jame JoyDepartment of Anaesthesiology and Critical Care, MOSC Medical College and Hospital, Kochi, Kerala, India.
Ankita DeyDepartment of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Rajasekar RamaduraiDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Adethen GunasekaranDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Propofol is one of the most used intravenous anesthetic agents in traumatic brain injury (TBI) patients undergoing emergency neurosurgical procedures. Despite being efficacious, its administration is associated with dose-related adverse effects. The use of adjuvants along with propofol aids in limiting its consumption, thereby mitigating the side effects related to propofol usage. This study aims to compare the safety and efficacy of dexmedetomidine-propofol versus fentanyl-propofol-based total intravenous anesthesia (TIVA) in adult TBI patients. Methods: A hundred patients posted for emergency evacuation of acute subdural hematoma were enrolled, and they were randomized into two groups of 50 each. Propofol-based TIVA with a Schneider target-controlled infusion model was used for induction and maintenance. Patients in Group F received fentanyl, and those in Group D received dexmedetomidine infusions as adjuvants. Advanced hemodynamic parameters were monitored. Intracranial pressure (ICP) and brain relaxation were measured after dural opening. The mean propofol consumption, number of additional fentanyl boluses, and blood samples for S100b (a biomarker of neuronal injury) were also collected. Results: The mean propofol consumption in Group D (88.7 ± 31.8 μg/kg/min) was lower when compared to Group F (107.9 ± 34.6 μg/kg/min), ( Conclusion: In TBI, dexmedetomidine as an adjunct to propofol-based TIVA results in a greater reduction in total propofol consumption and intraoperative opioid requirements while maintaining hemodynamic stability when compared to fentanyl.

Indexed as

Brain relaxationDexmedetomidinefentanylPropofolTotal intravenous anesthesiaTraumatic brain injury

Identifiers

PMID39777171
PMCPMC11704446

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.