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Comparison of propofol alone <i>vs</i> propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery.

Overview

Authors: Rhea Thotungal1, Ashutosh Kaushal1, Amit Agrawal2, Anuj Jain1, Vaishali Waindeskar1, Rudrashish Haldar3, Pfokreni Lokho1
  1. Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal 462026, Madhya Pradesh, India
  2. Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal 462026, Madhya Pradesh, India
  3. Department of Anesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Institutions: All India Institute of Medical Sciences Bhopal (India); Sanjay Gandhi Post Graduate Institute of Medical Sciences (India)
Journal: World journal of methodology, volume 16, issue 3, article 117220
Dates: received 8 December 2025; accepted 16 March 2026; published online 20 September 2026
Type: Research article · Language: English
License: CC BY-NC
Identifiers: DOI 10.5662/wjm.117220 · PMID 42626261 · PMCID PMC13491126 · OpenAlex W7163177445
Open access: diamond, a free copy (OpenAlex)
Status: code on request
Categories: other condition (population), clinical / translational (subfield)
Methods: Statistics, Connectivity
Keywords: Propofol, Phenylephrine, Hemodynamic stability, Glioma surgery, Induction of anesthesia, Neuroanesthesia, Brain relaxation
Topic: Cancer, Stress, Anesthesia, and Immune Response (Psychiatry and Mental health, Medicine), according to OpenAlex
Citations: not cited yet (Europe PMC); 22 references in the paper

Abstract

BACKGROUND: Propofol is widely used for induction in glioma surgery for its neuroprotective effects and favorable recovery profile. However, its dose-dependent hypotension is a major limitation in procedures requiring stable cerebral perfusion.

AIM: To compare the efficacy of propofol vs propofol-phenylephrine (PPE) combination in maintaining hemodynamic stability in patients undergoing glioma surgery.

METHODS: Ninety American Society of Anesthesiologists I-II patients scheduled for elective glioma surgery were randomized to receive either propofol (group P) or a PPE admixture (group PPE). Induction was performed with slow titration of the study drug until loss of verbal response and Bispectral index < 60, followed by a continuous infusion (50 μg/kg/minute) until skin closure. Hemodynamic parameters [mean arterial pressure (MAP), systolic blood pressure, diastolic blood pressure, and heart rate] were recorded at baseline, during induction, immediately after intubation, and at predefined intraoperative time points. The incidence of hypotension, vasopressor and esmolol use, and brain relaxation scores were compared.

RESULTS: Group PPE demonstrated significantly better preservation of MAP, systolic blood pressure, diastolic blood pressure, and heart rate throughout the peri-induction and intraoperative periods (P < 0.05). The mean maximum MAP reduction during induction was greater in group P compared with group PPE (19.7 mmHg vs 12.5 mmHg; P < 0.01). Hypotensive episodes were significantly more frequent in group P than in group PPE (84.4% vs 6.7%; P < 0.001). Rescue phenylephrine requirements were markedly lower in group PPE (P < 0.001). Esmolol use and brain relaxation scores were comparable between groups.

CONCLUSION: Adding phenylephrine to propofol for induction and maintenance provides superior hemodynamic stability without compromising brain relaxation in glioma surgery.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

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Versions

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 7 authors, 7 keywords, 22 references.

Cite

This paper

Thotungal, R., Kaushal, A., Agrawal, A., Jain, A., Waindeskar, V., Haldar, R., & Lokho, P. (2026). Comparison of propofol alone &lt;i&gt;vs&lt;/i&gt; propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery. World journal of methodology, 16(3), 117220. https://doi.org/10.5662/wjm.117220

BibTeX

@article{thotungal2026comparison,
author = {Thotungal, Rhea and Kaushal, Ashutosh and Agrawal, Amit and Jain, Anuj and Waindeskar, Vaishali and Haldar, Rudrashish and Lokho, Pfokreni},
title = {{Comparison of propofol alone \&lt;i\&gt;vs\&lt;/i\&gt; propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery}},
journal = {World journal of methodology},
year = {2026},
month = sep,
volume = {16},
number = {3},
pages = {117220},
publisher = {Baishideng Publishing Group Inc},
issn = {2222-0682},
doi = {10.5662/wjm.117220},
url = {https://doi.org/10.5662/wjm.117220},
pmid = {42626261},
pmcid = {PMC13491126}
}

RIS

TY - JOUR
AU - Thotungal, Rhea
AU - Kaushal, Ashutosh
AU - Agrawal, Amit
AU - Jain, Anuj
AU - Waindeskar, Vaishali
AU - Haldar, Rudrashish
AU - Lokho, Pfokreni
TI - Comparison of propofol alone &lt;i&gt;vs&lt;/i&gt; propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery
T2 - World journal of methodology
J2 - World J Methodol
PY - 2026
DA - 2026/09/20
VL - 16
IS - 3
SP - 117220
SN - 2222-0682
PB - Baishideng Publishing Group Inc
DO - 10.5662/wjm.117220
UR - https://doi.org/10.5662/wjm.117220
LA - en
ER -

CSL-JSON

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