Prevention of Blood Pressure Response to Skull-Pin Hiad Holder by Local Anesthesia

Colley, Peter S.; Dunn, R. L. R.

doi:10.1213/00000539-197905000-00015

Cited by 29 publications

(9 citation statements)

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“…They induce in insufficiently anesthetized patients significant hemodynamic response, increased stress hormones and in patients with impaired autoregulation may lead to increased intracranial pressure [4,5].…”

Section: Hemodynamic and Bispectral Changes During Pin Insertion In Cmentioning

confidence: 99%

Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

Durnev

Soljakova

Filipče

et al. 2017

Prilozi

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introductionCranial pins insertion is a method for head stabilization and together with the scalp incision is one of the biggest noxious stimulus associated with arousal and rapid increase of the blood pressure leading to pathological increase of the intracranial pressure. The aim of this investigation is to study the superiority of the locally infiltrated anesthetic bupivacaine just before the skull pin insertion and the scalp incision in craniotomy under general anesthesia. Methods In the study thirty patients of both genders aged 24-72 years were included. They were categorized as ASA 1 and 2 and divided into two group of 15 patients each, group B (bupivacaine) and group S (saline). We recorded the bispectral (BIS) index, the mean arterial pressure (MAP) and the pulse rate (PR) in five time intervals: t 0-2min before pin insertion; t 1-2 min after pin insertion; t 2-5 min after; t 3-10min after and t 4-15 min after. results Significant difference p<0.05 was achieved in group S for all three followed parameters: blood pressure, heart rate and bispectral index. The difference is present in all four time intervals compared to the initial one before the pin insertion. With further analysis it was demonstrated that the investigated BIS index participates the most in the overall significance in group F. conclusion The scalp infiltration with local anesthetic bupivacaine results with stable hemodynamic parameters and stable intracranial pressure during the painful procedures as craniotomy.

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Section: Hemodynamic and Bispectral Changes During Pin Insertion In Cmentioning

confidence: 99%

Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

Durnev

Soljakova

Filipče

et al. 2017

Prilozi

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“…2 The haemodynamic consequences can be successfully obtunded by prior local anaesthetic infiltration of the scalp at pin sites. [3][4][5] Many studies have been published on the dangers of such blood pressure increases resulting from skull pin application, but no one has investigated the effect of skull pinning on intraocular pressure (IOP). This prompted us to conduct this study in patients undergoing cervical spine surgery followed by iliac crest graft placement.…”

Section: Introductionmentioning

confidence: 99%

Lidocaine infiltration of the scalp does not completely abolish increased intraocular pressure due to skull pin insertion

Bithal

Pandia

Chaturvedi

et al. 2006

Journal of Clinical Neuroscience

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“…

under anesthesia and it has decreased the incidence of intraoperative awareness [5,6].Hypertension and tachycardia are the prominent hemodynamic responses observed on noxious stimulation of the scalp [7,8]. Such scalp stimulation may be the result of scalp incision or skull pin fi xation.

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mentioning

confidence: 99%

“…This evokes a strong nociceptive input, thereby causing acute hypertension and tachycardia. These hemodynamic changes can be obtunded by infi ltration of the scalp with local anesthetic [7][8][9] or by skull block prior to pin placement [10]. We hypothesized that BIS would increase when skull pins were attached without any adjuvant, if anesthetic depth was inadequate even in the presence of an inhalation agent, whereas it would remain unchanged when the pins were attached following local anesthetic infi ltration of the scalp, which blocks nociceptive responses.…”

mentioning

confidence: 99%

Hemodynamic and bispectral index changes following skull pin attachment with and without local anesthetic infiltration of the scalp

et al. 2007

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We studied the hemodynamic and bispectral index (BIS) changes in 44 patients undergoing cervical diskectomy with attachment of a Gardner-Wells tong (with two sharp conical pins) to the skull to facilitate intraoperative bone graft insertion. Patients were induced with fentanyl, thiopentone, and rocuronium and maintained with 66% nitrous oxide and 0.5% isoflurane, Before insertion of the pins, patients were randomly allocated to have either saline or lidocaine infiltration of the scalp at the proposed pin sites. Two minutes later, the pins were driven into the scalp. The BIS, mean arterial pressure (MAP), and heart rate (HR) were recorded before (baseline) and at 30, 60, 90, and 120 s after pin insertion. Data were compared with the baseline values and between the groups. A significant increase in MAP and HR occurred throughout the study period in the saline group. Skull pinning increased BIS throughout the study period in the saline group only, with maximal increases observed at 90 and 120 s (66.1 +/- 6.3 at 90 s and 65.7 +/- 6.4 at 120 s versus a baseline value of 62 +/- 8, P < 0.001). The increase in BIS was significant in the saline group compared with the lidocaine group at each time point. In conclusion, increases in MAP, HR, and BIS produced by skull pinning were prevented by prior local anesthetic infiltration.

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Prevention of Blood Pressure Response to Skull-Pin Hiad Holder by Local Anesthesia

Cited by 29 publications

References 0 publications

Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

Lidocaine infiltration of the scalp does not completely abolish increased intraocular pressure due to skull pin insertion

Hemodynamic and bispectral index changes following skull pin attachment with and without local anesthetic infiltration of the scalp

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