Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 8/ Issue 01/ Jan. 07, 2019 Page 14 COMPARISON OF PROPOFOL/DEXMEDETOMIDINE FOR ASLEEP AWAKE ASLEEP TECHNIQUE FOR AWAKE CRANIOTOMIES IN TERTIARY CARE HOSPITAL Manisha S. Kapdi 1 , Rupal J. Shah 2 , Shvangi Patel 3 , Manhar G. Vachhani 4 , Nidhi Patel 5 1 Associate Professor, Department of Anaesthesia, NHLM Medical College, Ahmedabad, Gujarat, India. 2 Associate Professor, Department of Anaesthesia, AMCMET College, Ahmedabad, Gujarat, India. 3 Resident, Department of Anaesthesia, NHLM Medical College, Ahmedabad, Gujarat, India. 4 Resident, Department of Anaesthesia, NHLM Medical College, Ahmedabad, Gujarat, India. 5 Resident, Department of Anaesthesia, NHLM Medical College, Ahmedabad, Gujarat, India. ABSTRACT BACKGROUND Awake craniotomy is an important technique used for brain tumour excision from eloquent cortex, epilepsy foci removal surgery, deep brain stimulation, less commonly for mycotic aneurysms, A-V malformation near cortical areas. Aims and Objectives- To access quality of brain mapping, haemodynamic stability, perioperative airway security, & observation of adverse effects in propofol, dexmedetomidine groups for awake craniotomies. Group Allocation- (Maintenance of anaesthesia in both groups was different as follows :) Group A (Propofol Group): inj. propofol 6 mg/kg/hour for 10 min, then 4 mg/kg/hour. (n=25) Group B (Dexmedetomidine group): Inj. dexmedetomidine 0.5 mg/kg/hour (n=25). MATERIALS & METHODS This randomised double-blind comparative study of premedication- Inj. glycopyrrolate 0.04 mg/kg, inj. ondansetron 0.08 mg/kg & in fentanyl 1 mcg/kg. Scalp block: scalp block was given with inj. Ropivacaine 0.5% 30 ml to block supraorbital, supratrochlear, zygomatic temporal, auriculotemporal nerves, greater auricular, lesser auricular nerves in General Hospital, NHLM medical college, Ahmedabad, Gujarat, India. Induction- Induction was done with inj. thiopentone 5 to 7 mg/kg IV. Airway security- By i-gel (second generation laryngeal mask airway) Maintenance- In group A: inj. propofol 6 mg/kg/hour for first 10 min then 4 mg/kg/hour In group B: inj. dexmedetomidine 1 mcg/kg/hour for first 10 min then 0.5 mcg/kg/hour When neurosurgeon wanted to perform brain mapping, patient's i-gel was removed & patients were managed with low dose of propofol & dexmedetomidine in awake period, then further dose was increased in 3rd phase, that is asleep period. RESULTS NRS score of cortical mapping was comparable in both groups-  In both groups haemodynamic variables were stable & comparable.  In group B better airway management & less complications observed. CONCLUSION In AAA method for awake craniotomies, use of dexmedetomidine is a good alternative to propofol. KEYWORDS Awake Craniotomy, AAA Method, Dexmedetomidine, Propofol, i-gel, Scalp Block. HOW TO CITE THIS ARTICLE: Kapdi MS, Shah RJ, Patel S, et al. Comparison of propofol/dexmedetomidine for asleep awake asleep technique for awake craniotomies in tertiary care hospital. J. Evolution Med. Dent. Sci. 2019;8(01):14-18, DOI: 10.14260/jemds/2019/4 BACKGROUND Awake craniotomy is popular since 2 decades. It is usually performed for epilepsy surgery, temporal lobectomy, which encroaches eloquent cortex, motor, speech areas, Deep brain stimulation, for AV malformation which needs intraoperative ‘Financial or Other Competing Interest’: None. Submission 28-11-2018, Peer Review 23-12-2018, Acceptance 31-12-2018, Published 07-01-2019. Corresponding Author: Dr. Manisha S. Kapdi, Associate Professor, Department of Anaesthesia, NHLM Medical College, Ahmedabad, Gujarat, India. E-mail: manisha_kapdi@yahoo.com DOI: 10.14260/jemds/2019/4 functional testing, Cortical mapping, which requires patient to be awake. (1,2) Main advantage of awake surgery is to define limits of resection & avoid Postoperative neurological deficits. Maintaining patient’s cooperation by provision of optimal analgesia, sedation, anxiolysis and comfortable position, achieving homeostasis with safe airway, adequate ventilation and hemodynamic stability, Ensure minimal interference with electrocortico graphic recording during mapping. Main Objective of the study was to access Brain mapping by NRS scale, Haemodynamic Stability, & adverse effects with both study drugs dexmedetomidine or propofol. MATERIALS AND METHODS This Randomised double-blind comparative study of 50 adult elective patients with mass near the eloquent area with ASA