The effect of bupivacaine skull block on the hemodynamic response to craniotomy
| Autor: | Richard L. Fishman, Susan C. Harvey, Patel S, Palesch Y, Scott Reeves, Mark L. Pinosky, B.H. Dorman |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Mean arterial pressure Adolescent Intracranial Pressure medicine.medical_treatment Hemodynamics Blood Pressure Trochlear Nerve Bone Nails Double-Blind Method Heart Rate Periosteum Tachycardia medicine Tidal Volume Humans Prospective Studies Ear External Craniotomy Intracranial pressure Aged Bupivacaine Aged 80 and over Scalp Isoflurane business.industry Temporal Bone Nerve Block Middle Aged Skull Anesthesiology and Pain Medicine Blood pressure medicine.anatomical_structure Anesthesia Occipital Bone Anesthetics Inhalation Hypertension Nerve block business Orbit medicine.drug |
| Zdroj: | Anesthesia and analgesia. 83(6) |
| ISSN: | 0003-2999 |
| Popis: | The placement of pointed cranial pins into the periosteum is a recognized acute noxious stimulation during intracranial surgery which can result in sudden increases in blood pressure and heart rate, causing increases in intracranial pressure. A skull block (blockade of the nerves that innervate the scalp, including the greater and lesser occipital nerves, the supraorbital and supratrochlear nerves, the auriculotemporal nerves, and the greater auricular nerves) may be effective in reducing hypertension and tachycardia. Twenty-one patients were allocated in a prospective, double-blind fashion to a control group or a bupivacaine group. After a standardized induction and 5 min prior to head pinning, a skull block was performed. Patients in the control group received a skull block of normal saline, while the bupivacaine group received a skull block with 0.5% bupivacaine. Systolic (SAP), diastolic (DAP), mean arterial pressure (MAP), heart rate (HR), and end-tidal isoflurane were recorded at the following times: 5 min after the induction of anesthesia, during performance of the skull block, during head pinning, and 5 min after head pinning. Significant increases in SAP of 40 +/- 6 mm Hg, DAP of 30 +/- 5 mm Hg, MAP of 32 +/- 6 mm Hg, and HR of 22 +/- 5 bpm occurred during head pinning in the control group, while remaining unchanged in the bupivacaine group. These results demonstrate that a skull block using 0.5% bupivacaine successfully blunts the hemodynamic response to head pinning. |
| Databáze: | OpenAIRE |
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