Effect of adjunctive lidocaine-based scalp block and laryngotracheal local anesthesia vs general anesthesia only on plasma and cerebrospinal fluid pro-inflammatory cytokine concentrations in patients with cerebral aneurysm: a randomized controlled trial
| Autor: | Ante Sekulić, Bálint Nagy, Robert Likić, Vlatka Sotošek, Goran Mrak, Marijana Matas, Ana Kozmar |
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| Rok vydání: | 2021 |
| Předmět: |
Brain aneurysm
Lidocaine Anesthesia General law.invention BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Anesteziologija i reanimatologija Aneurysm Cerebrospinal fluid Randomized controlled trial law Intracranial Aneurysm* / surgery medicine Humans anesthesia general anesthesia local anesthetics local cytokines Local anesthesia Anesthetics Local Scalp business.industry Intracranial Aneurysm* / drug therapy BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Anesthesiology and Reanimatology Intracranial Aneurysm General Medicine medicine.disease medicine.anatomical_structure Anesthesia Anesthesia General Anesthesia Local Anesthetics Local Cytokines Cytokines Complication business Research Article Anesthesia Local medicine.drug |
| Zdroj: | Croatian Medical Journal Volume 62 Issue 4 |
| ISSN: | 1332-8166 0353-9504 0382-3482 |
| DOI: | 10.3325/cmj.2021.62.338 |
| Popis: | Aim To compare the effect of adjunctive lidocaine-based scalp block and laryngotracheal local anesthesia vs general anesthesia only on pro-inflammatory cytokine concentrations in patients with non-ruptured brain aneurysms undergoing elective open surgery. Methods This parallel, randomized, controlled, open-label trial was conducted at Clinical Hospital Center Zagreb between March 2019 and March 2020. At the beginning of anesthesia, lidocaine group received 40 mg of 2% lidocaine for laryngotracheal topical anesthesia and 4 mg/kg for the scalp block. Control group underwent general anesthesia only. Plasma concentrations of IL-6, TNF-α, and IL-1β were measured before anesthesia (S0); at the incision (S1); at the end of surgery (S2); 24 hours postoperatively (S3). Cerebrospinal fluid (CSF) cytokine concentrations were measured at the incision (L1) and the end of surgery (L2). Results Forty patients (each group, 20) were randomized; 37 were left in the final analysis. IL-6 plasma concentrations increased significantly compared with baseline at S3 in lidocaine group, and at S2 and S3 in control group. In both groups, changes in TNF-α and IL-1β were not significant. CSF cytokine concentrations in lidocaine group did not change significantly; in control group IL-6 and IL-1β were significantly higher at L2 than at L1. CSF IL-6 in control group significantly increased at L2, but TNF-α and IL-1β did not. No differences in clinical outcome and complication rates were observed. Conclusion Adjunctive lidocaine-based scalp block and laryngotracheal local anesthesia might attenuate CSF IL-6 concentration increase in patients with brain aneurysm. Trial registration Clinical Trials NCT03823482 |
| Databáze: | OpenAIRE |
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