Effect of scalp infiltration with lidocaine on the circulatory response to craniotomy.

BACKGROUND

The purpose of the present study was to evaluate the influence of infiltration anesthesia of the projected line of incision in the skin of head on the hemodynamic response of 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 projected line of skin incision was injected with a 1% lidocaine solution (9.94+/-1.95 ml) five minutes before commencing surgery.

RESULTS

No statistically significant differences were found between the various groups 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 significant increase in MAP values (P<0.05) caused by skin incision was recorded in groups IA (from 95.2+/-9.85 to 119+/-10.6 mm Hg) and IB (from 88.4+/-11.5 to 100.3+/-11.4 mm Hg). 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.