The Hemodynamic Effects of Ropivacaine Infiltration at the Skull-pin Insertion Sites and the Incision Site in Craniotomy.

Choi,  Jong Cheol; Jeong,  Chang Young; Kwak,  Sang Hyun; Yoon,  Myung Ha

doi:2003.45.2.194

Clinical Research Article

Korean Journal of Anesthesiology 2003;45(2):194-199.
DOI: https://doi.org/10.4097/kjae.2003.45.2.194

The Hemodynamic Effects of Ropivacaine Infiltration at the Skull-pin Insertion Sites and the Incision Site in Craniotomy.

Jong Cheol Choi, Chang Young Jeong, Sang Hyun Kwak, Myung Ha Yoon

Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea. mhyoon@chonnam.ac.kr

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 ropivacaine infiltration on hemodynamics followed by the skull-pin head-holder application and the skin incision.
METHODS
Sixty-six patients who had been scheduled for neurosurgery under general anesthesia were randomly divided into five groups. Saline or different concentrations of ropivacaine (0.1, 0.2, 0.5, 0.75%) were infiltrated into skull-pin head-holder insertion sites and the skin incision site. Systolic and diastolic blood pressure, 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
The systolic blood pressure (SBP) significantly increased on 30 sec and 1 min after skull-pin head-holder application, and on 30 sec, 1 min, 3 min, and 5 min after skin incision in the saline group and in the 0.1% ropivacaine group, respectively. Increased SBP was attenuated by 0.75% ropivacaine over the entire observation period. Increased diastolic blood pressure was reduced by 0.5% and 0.75% of ropivacaine at all times. The heart rate significantly increased on 30 sec and 1 min after skull-pin head-holder application in the saline group and in the 0.1% group. This increased heart rate was suppressed by 0.2%, 0.5%, and 0.75% ropivacaine.
CONCLUSIONS
These results indicate that ropivacaine attenuates the hemodynamic responses evoked by skull-pin head-holder application or skin incision in craniotomy. Ropivacaine was most active at 0.75%.

Key Words: craniotomy; hemodynamics; infiltration; ropivacaine