Abstract No. : ABS2675: Effects of avoiding neuromuscular blocking agents during maintenance of anaesthesia for recovery characteristics in patients undergoing craniotomy supratentorial lesions: A randomised controlled trial.

BACKGROUND & AIMS: With the advent of newer anesthetic techniques, the utility of neuromuscular blocking agents (NMBA) in neuroanaesthesia seems dispensable. The aim was to determine whether NMBAs are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used. METHODS: Sixty patients with American society of anesthesiologists physical status I/II, aged between 18 & 60years were included. All patients received general anaesthesia along with desflurane, dexmedetomidine and scalp block. The patients were randomly allocated to receive no NMBA (groupA) or atracurium infusion to maintain a train of four count 2 (groupB). The two groups were compared with respect to haemodynamic stability, brain relaxation scores and recovery characteristics. Haemodynamic parameters and time taken to achieve Aldrete score >9 and secondary outcomes were analysed using Student’s t-test. Non-parametric data were analysed using the Mann-Whitney test. RESULTS: The mean arterial pressure and intraoperative heart rate were comparable between the groups. However, in the postoperative period, heart rate remained higher in group B for 30 min after extubation (p=0.02). The brain relaxation scores were comparable among the groups (p=0.27).Tracheal extubation time, time taken for orientation and time required to reach Aldrete score >9 were comparable among the two groups. CONCLUSION: The present study suggested that balanced anaesthesia using desflurane, dexmedetomidine and scalp block can preclude the use of neuromuscular blocking agents in patients undergoing supratentorial surgery under intense haemodynamic monitoring.