A comparison of alfentanil, esmolol, lidocaine, and thiopental sodium on the hemodynamic response to insertion of headrest skull pins

Doblar, Dennis D.; Lim, Y. C.; Baykan, Nigar; Frenette, Luc

doi:10.1016/0952-8180(95)00169-7

Cited by 29 publications

(21 citation statements)

References 17 publications

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“…1 Increases in ICP can affect cerebral perfusion pressure (CPP) resulting in increased intracranial blood flow, cerebral edema, and rupture of intracranial aneurysms. 1 The various methods used to attenuate the hemodynamic response to insertion of skull pins include use of a 2 agonists such as dexmedetomidine, 2 and clonidine, 3,4 local anesthetic infiltration at pin sites, 5-7 scalp blocks, 7 opioids, [8][9][10][11][12] b blockers, 12 subanesthetic dose of ketamine, 13 and deepening of general anesthesia. 14 Gabapentin, a newer antiepileptic drug, is commonly used in the perioperative period to reduce opioid requirements and to decrease postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

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Gabapentin Premedication Decreases the Hemodynamic Response to Skull Pin Insertion in Patients Undergoing Craniotomy

Misra

Koshy

Unnikrishnan

et al. 2011

Journal of Neurosurgical Anesthesiology

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In conclusion, 900 mg of gabapentin, administered orally 2 hours before induction of anesthesia along with lidocaine scalp infiltration abolished the hemodynamic response after skull pin insertion. Premedication with gabapentin alone significantly attenuated the SBP and MAP; however, HR responses were more variable. A larger trial is required to corroborate the findings of the study before clinical recommendations would be warranted.

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Section: Discussionmentioning

confidence: 99%

“…A similar effect has also been observed with the other a 2 agonist, clonidine. 3,4 Opioids such as fentanyl, 8-10 sufentanil, 10,11 and alfentanil, 12 have also been found to attenuate the hemodynamic response to skull pin insertion.…”

Section: Discussionmentioning

confidence: 99%

Gabapentin Premedication Decreases the Hemodynamic Response to Skull Pin Insertion in Patients Undergoing Craniotomy

Misra

Koshy

Unnikrishnan

et al. 2011

Journal of Neurosurgical Anesthesiology

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“…14 Many workers have used esmolol(cardio selective beta blocker), 15 metoprolol, 16,17 and Labetalol 18,19,12 as a bolus and in infusion and found it to be effective to attenuate intubation responses, to prevent perioperative cardiovascular events and for haemodynamic stability.…”

Section: Discussionmentioning

confidence: 99%

“…Opiod analgesics are widely used because they provide a good haemodynamic stability against surgical stimuli without causing a severe change in cerebrospinal fluid pressure and cerebral perfusion. 7,8 But narcotics alone are not sufficient to prevent a haemodynamic response to skull pin insertion. 9 So there is a need to combine other drug with fentanyl.…”

Section: Introductionmentioning

confidence: 99%

Comparison of effect of Labetalol and fentanyl with only fentanyl for attenuating pressure responses to intubation and skull pin insertion in neurosurgery

2020

IJCA

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“…26,29,30 The undesired effects of opioids may be modified by atropine and phenylephrine; however, narcotics alone are not sufficient to prevent a hemodynamic response to skull-pin head holder placement. Rubial 31 showed that local anesthetic infiltration at the pin sites was more effective than IV fentanyl 3 µg/kg to 5 µg/kg.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Fentanyl and/or Lidocaine on Total Antioxidants and Total Oxidants During Craniotomy

Mızrak¹,

Erkutlu²,

Alptekin³

et al. 2011

Clinical Medicine & Research

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Objective: The aim of this study was to investigate the oxidative, hemodynamic, and analgesic effects of local lidocaine infiltration, or intravenous (IV) fentanyl injection, or a combination of lidocaine and IV fentanyl during head fixation in a 3-pin headrest in patients undergoing elective craniotomy.Design: Double-blind, randomized, placebo-controlled study. Setting: Gaziantep University Medical Faculty, Department of Anesthesiology and Reanimation.Methods: Eighty patients were randomly assigned to one of four groups. Five minutes before pin fixation, patients in group L received 1 mg/kg of lidocaine 2% for scalp infiltration (n=20), group F received 1 µg/kg of IV fentanyl (n=20), group FL received 1 mg/kg of lidocaine 2% and 1 µg/kg of fentanyl (n=20), and group P received a placebo (n=20). Following standard anesthesia, basal, pre-and post-fixational hemodynamic data were recorded. Blood samples were taken for evaluation of oxidant and antioxidant levels before and after pin fixation. Results:The total antioxidant levels after pin fixation were highest in group FL followed by group F, then group L and finally group P (ie, FL>F>L>P) (P<0.05). The mean arterial blood pressure (MAP) after pin fixation was higher than the MAP before pin fixation in groups L and P (P<0.05), but was lower in groups F and FL (P<0.05). Conclusion:The combination of fentanyl and lidocaine before pin fixation is useful in preventing severe hemodynamic response to pain stimuli, such as pin fixation, and in increasing total antioxidant levels in the post-fixational period during craniotomy in adults.

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A comparison of alfentanil, esmolol, lidocaine, and thiopental sodium on the hemodynamic response to insertion of headrest skull pins

Cited by 29 publications

References 17 publications

Gabapentin Premedication Decreases the Hemodynamic Response to Skull Pin Insertion in Patients Undergoing Craniotomy

Gabapentin Premedication Decreases the Hemodynamic Response to Skull Pin Insertion in Patients Undergoing Craniotomy

Comparison of effect of Labetalol and fentanyl with only fentanyl for attenuating pressure responses to intubation and skull pin insertion in neurosurgery

Efficacy of Fentanyl and/or Lidocaine on Total Antioxidants and Total Oxidants During Craniotomy

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