| The Hemodynamic Effects of Levobupivacaine Infiltration at the Skull-pin Insertion Site and the Incision Site in Craniotomy. |
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Dong Jin Shin, Hong Beom Bae, Jeong Il Choi, Myung Ha Yoon |
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Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea. mhyoon@chonnam.ac.kr |
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| 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. |
| Key Words:
hemodynamics; levobupivacaine; skull-pin head-holder |
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