If the anesthetic regimen can influence the serum level of inflammatory cytokines and if the
levels of cytokines are related to the incidence of post operative complications, these
complications may be a function of the anesthetic method. In an effort to find the best
anesthetic regimen for patients undergoing craniotomy for intracranial tumors, the
researchers will compare the effect of volatile anesthetic with that of total intravenous
anesthesia (TIVA) on cytokine levels. The researchers will also compare the composite
incidence of some common major post-operative complications after craniotomy for
This is a randomized blinded clinical trial. Patients will be randomized into one of two
groups. One group will receive a volatile anesthetic (sevoflurane)while the other group will
receive intravenous anesthetics (propofol + remifentanil) for maintenance of General
The anesthesia team will know the result of randomization at induction. Postoperative data
will be gathered by research personnel who will be blinded to the anesthetic method used.
Patients will be blinded to the anesthetic they receive until after the 4-week outcomes are
collected, when they will have the option to be unblinded.
Peripheral blood samples will be taken a total of 7 times; pre-induction to anesthesia, 15
minutes after surgical positioning, after the tumor is extracted, and at 6,12,18, and 24
hours after emergence from anesthesia.
Patients will be called for follow up every week for 4 weeks following discharge.
- Patients undergoing general anesthesia for elective surgical excision of a primary
- Age: Older than 18
- New and recurrent cases will be included
- Patient refusal
- Emergency craniotomy
- Craniotomy after head injuries or intracranial bleeding
- Patients with active inflammatory processes such as infection or immunologic
illnesses known to increase baseline immunologic markers
- Preoperative diagnosis of DVT by lower extremity ultrasound or symptoms
- Preoperative pulmonary infiltrative disease (pulmonary fibrosis, sarcoid, etc.)