The Hemodynamic Effects of Levobupivacaine Infiltration at the Skull-pin Insertion Site and the Incision Site in Craniotomy.
10.4097/kjae.2006.51.2.179
- Author:
Dong Jin SHIN
1
;
Hong Beom BAE
;
Jeong Il CHOI
;
Myung Ha YOON
Author Information
1. Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea. mhyoon@chonnam.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
hemodynamics;
levobupivacaine;
skull-pin head-holder
- MeSH:
Anesthesia;
Anesthesia, General;
Blood Pressure;
Craniotomy*;
Heart Rate;
Hemodynamics*;
Humans;
Neurosurgery;
Skin
- From:Korean Journal of Anesthesiology
2006;51(2):179-184
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Several drugs have been used to reduce the hemodynamic responses evoked by skull-pin head-holder application and skin incision in neurosurgery. This study evaluated the effects of levobupivacaine infiltration on hemodynamics followed by the skull-pin head-holder application and the skin incision. METHODS: Eighty-eight patients who had been scheduled for neurosurgery under general anesthesia were randomly divided into five groups. Saline or different concentrations of levobupivacaine (1, 2.5, 5, 7.5 mg/ml) were infiltrated into skull-pin head-holder insertion sites and the skin incision sites. Systolic (SBP) and diastolic blood pressure (DBP) and heart rate were measured just before skull-pin head-holder application and 30 sec, 1 min, 3 min and 5 min after skull-pin head-holder application and skin incision. Changes in hemodynamics were compared. RESULTS: SBP, DBP and heart rate significantly increased after skull-pin head-holder application. The range of increase was diminished by local application of levobupivacaine. However, 5 mg/ml and 7.5 mg/ml levobupivacaine group decreased blood pressure or heart rate to below the baseline after skin incision. CONCLUSIONS: These results indicate that 7.5 mg/ml levobupivacaine attenuates the hemodynamic responses evoked by skull-pin head-holder application, but decreases blood pressure and heart rate after skin incision in craniotomy. Therefore, 5 mg/ml levobupivacaine was effective minimum local concentration to attenuate the change of hemodynamics by skull-pin head-holder application and skin incision in craniotomy if the level of anesthesia is maintained properly.
