CLINICAL EFFICACY OF SCALP INFILTRATION WITH 0.25% LEVOBUPIVACAINE TO ATTENUATE HEMODYNAMIC RESPONSE TO SKULL PIN INSERTION IN SUPRATENTORIAL CRANIOTOMIES UNDER GENERAL ANESTHESIA

Volume : VII, Issue : V, May - 2018

Dr Veena Ganeriwal, Dr Paulomi Dey

Sudden hemodynamic changes caused by skull pins in neurosurgery can be prevented by scalp block which blocks both the

superficial and deep layers of the scalp.Levobupivacaine has been used in 0.75% and 0.5 % concentrations for this purpose. No

previous study has determined the efficacy of 0.25% levobupivacaine for scalp block. This prospective observational study

included 50 patients, after obtaining approval from ethics committee of Grant Govt Medical College & Sir J.J Hospital and written

informed consent from patients who underwent supratentorial craniotomy at this institute. Scalp block with 20ml of 0.25%

levobupivacaine was given bilaterally after induction of general anesthesia and prior to application of Mayfield skull pin head

holder. The hemodynamic parameters were recorded at baseline, during scalp block and after head pin insertion, incision and

craniotomy. Values of heart rate and blood pressure before and after anesthesia induction compared to values after painful

stimuli were in the 10 to 15% range. Mean intraoperative Fentanyl requirement was 150 micrograms (2–3microgm/kg)

Keywords: levobupivacaine; neuroanesthesia; scalp block.