Dewi Arum Sawitri
Faculty of Medicine Universitas Brawijaya Malang, Indonesia

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TCI of Propofol Combined with Multimodal Analgesia for Neurophysiological Intraoperative Monitoring during Craniotomy for Meckel's Cave Meningioma Resection Ella Priliandini; Buyung Hartiyo Laksono; Eko Nofiyanto; Dewi Arum Sawitri
Jurnal Neuroanestesi Indonesia Vol 15, No 2 (2026)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v15i2.745

Abstract

Introduction: Meckel’s cave meningioma is an intracranial tumor located in close proximity to critical neurovascular structures. An effective anesthetic strategy is essential to optimize outcomes and minimize complications.Case: A 38-year-old woman with progressive ptosis, diplopia, and proptosis was diagnosed with Meckel’s cave meningioma. She underwent craniotomy with intraoperative neurophysiological monitoring (IOM) under general anesthesia managed with Target-Controlled Infusion (TCI) of propofol and dexmedetomidine. TCI of propofol, with Schnider mode was adjusted to a target effect concentration of 2-6 μg/mL. Dexmedetomidine was administered at a dose of 0.3-0.7 mcg/kg/hour. A multimodal analgesic approach, including scalp block with ropivacaine and dexamethasone was performed to reduce opioid consumption and manage pain. The procedure was completed without complications. Postoperatively, the patient demonstrated stable hemodynamics, no new neurologic deficits, and effective pain control.Discussion: Anesthesia protocol, including propofol TCI and dexmedetomidine, was performed to maintain signal integrity, allowing safe tumor resection while minimizing the risk of postoperative deficits. The combination of propofol TCI, dexmedetomidine, and multimodal analgesia was shown to achieve stable hemodynamic and neurophysiological conditions during craniotomy for Meckel’s cave meningioma.Conclusion: The combination of propofol TCI, dexmedetomidine, and multimodal analgesia is effective in maintaining stable hemodynamic and neurophysiological conditions during craniotomy for Meckel’s cave meningioma.