Jurnal Neuroanestesi Indonesia
Vol 15, No 2 (2026)

TCI of Propofol Combined with Multimodal Analgesia for Neurophysiological Intraoperative Monitoring during Craniotomy for Meckel's Cave Meningioma Resection

Ella Priliandini (1Anesthesiology and Intensive Therapy Resident, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar Hospital, East Java)
Buyung Hartiyo Laksono (Faculty of Medicine Universitas Brawijaya Malang, Indonesia)
Eko Nofiyanto (Faculty of Medicine Universitas Brawijaya Malang, Indonesia)
Dewi Arum Sawitri (Faculty of Medicine Universitas Brawijaya Malang, Indonesia)



Article Info

Publish Date
20 Jun 2026

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.

Copyrights © 2026






Journal Info

Abbrev

jni

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health

Description

Editor of the magazine Journal of Neuroanestesi Indonesia receives neuroscientific articles in the form of research reports, case reports, literature review, either clinically or to the biomolecular level, as well as letters to the editor. Manuscript under consideration that may be uploaded is a ...