Korean J Anesthesiol Search

CLOSE


Korean J Anesthesiol > Volume 44(1); 2003 > Article
Korean Journal of Anesthesiology 2003;44(1):73-77.
DOI: https://doi.org/10.4097/kjae.2003.44.1.73   
The Effect of Skull Pin Fixation on Cerebrospinal Fluid Pressure and Cerebral Perfusion Pressure: Influence of Lidocaine and Fentanyl.
Hyun Kyung Lim, Jung Uk Han, Choon Soo Lee, Jang Ho Song, Kyung Hoon Lee, Hyun Sun Park, Hae Jin Park, Ji Sun Park, Chong Kweon Chung
1Department of Anesthesiology, College of Medicine, Inha University, Inchon, Korea. cck1264@unitel.co.kr
2Department of Pharmacology, College of Medicine, Inha University, Inchon, Korea.
3Department of Neurosurgery, College of Medicine, Inha University, Inchon, Korea.
Abstract
BACKGROUND
A hypertensive response is seen when a skull pin is inserted for a craniotomy. The risk of morbidity and mortality is high in patients with intracranial pathology. Many methods have been introduced to overcome the problem. We compared the hemodynamic effects and changes of intracranial pressure when we used lidocaine or fentanyl for blunting the hypertensive response.
METHODS
Thirty-two patients scheduled for a craniectomy were divided into two groups: an IV (intravenous) bolus of fentanyl (2micro gram/kg) group or lidocaine (1.5 mg/kg) group. An anesthesia was induced with fentanyl (2micro gram/kg), thiopental (5-7 mg/kg), lidocaine (1.5 mg/kg) and vecuronium (0.1 mg/kg), and was maintained with isoflurane 1 MAC (minimum alveolar anesthetic concentration) in nitrous oxide 50% and oxygen. After induction of anesthesia, a lumbar subarachnoid catheter was inserted for CSFP (cerebrospinal fluid pressure) measurement. An IV bolus of either fentanyl (2micro gram/kg) or lidocaine (1.5 mg/kg) was administered prior to insertion of the skull pin by a randomized method. CSFP, MAP (mean arterial pressure), and HR (heart rate) were measured before and 5 min after induction of anesthesia, immediately before and each mininute for five measurements after skull pin insertion.
RESULTS
There were no intergroup differences in the values of CSFP and HR. The MAP increased 9+/-14 (mean+/-SD) mmHg and 4+/-12 (mean+/-SD) mmHg 1 min after the skull pin insertion compared with immediately before skull pin insertion in the fentanyl group and lidocaine group respectively. The MAP recovered 2 min after the skull pin insertion in both groups. CPP (cerebral perfusion pressure) recovered 3 min and 2 min after the skull pin insertion in the fentanyl group and lidocaine group respectively.
CONCLUSIONS
An IV bolus of either fentanyl or lidocaine before skull pin insertion resulted in a stable value of CSFP, CPP and HR.
Key Words: Cerebrospinal fluid; fentanyl; intracranial pressure; lidocaine; perfusion pressue
TOOLS
Share :
Facebook Twitter Linked In Line it
METRICS Graph View
  • 0 Crossref
  •    
  • 981 View
  • 5 Download


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
101-3503, Lotte Castle President, 109 Mapo-daero, Mapo-gu, Seoul 04146, Korea
Tel: +82-2-792-5128    Fax: +82-2-792-4089    E-mail: journal@anesthesia.or.kr                

Copyright © 2023 by Korean Society of Anesthesiologists.

Developed in M2PI

Close layer
prev next