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Effect of scalp infiltration with lidocaine on the circulatory response tocraniotomy.

Cezary Pakulski, Rafał Nowicki, Beata Badowicz, Piotr Bąk, Krzysztof Mikulski, Beata Wojnarska

Med Sci Monit 2001; 7(4): CR725-728

ID: 421079

BACKGROUND: The purpose of the present study was to evaluate the influenceof infiltration anesthesia of the projected line of incision in the skin of head on the hemodynamic responseof the circulatory system, and the essential dose of opioids in 100 patients who underwent craniotomy.
MATERIAL AND METHODS: The patients were divided into 4 groups: IA - brain tumors, no infiltration anesthesia;IB - cerebral aneurysms, no infiltration anesthesia; IIA - brain tumors + infiltration anesthesia; IIB- cerebral aneurysms + infiltration anesthesia. In the patients from groups IIA and IIB, the projectedline of skin incision was injected with a 1% lidocaine solution (9.94+/-1.95 ml) five minutes beforecommencing surgery.
RESULTS: No statistically significant differences were found between the variousgroups in regards to their weight, the time between infusion of the first dose of fentanyl and skin incision,the mean heart rates at time points T1 (prior to induction of anesthesia), T2 (prior to skin incision)or T3 (after skin incision), or mean arterial pressure values (MAP) at time points T1 or T2. A significantincrease in MAP values (P<0.05) caused by skin incision was recorded in groups IA (from 95.2±9.85 to 119±10.6 mmHg) and IB (from 88.4±11.5 to 100.3±11.4 mmHg). In group IIA, MAP increased insignificantly, while in group IIB the MAP values did not change.
CONCLUSIONS: Infiltration anesthesia of the projected line of skin incision in the head enabled maintenance of stability in the circulatory system and lower doses of opioids administered before commencing surgery

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