Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2021.62.33 8
Effect of adjunctive lidocainebased scalp block and laryngotracheal local anesthesia vs general anesthesia only on plasma and cerebrospinal fluid pro-inflammatory cytokine concentrations in patients with cerebral aneurysm: a randomized controlled trial
Marijana Matas
orcid.org/0000-0002-8942-8964
; Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Vlatka Sotošek
; Department of Anesthesiology, Resuscitation, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Ana Kozmar
; Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
Robert Likić
; Department of Internal Medicine, Unit of Clinical Pharmacology, University Hospital Center Zagreb, Zagreb, Croatia
Goran Mrak
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb University School of Medicine, Zagreb, Croatia
Bálint Nagy
; Department of Anesthesiology and Intensive Therapy, Medical School, University of Pécs, Pécs, Hungary
Ante Sekulić
; Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Sažetak
Aim To compare the effect of adjunctive lidocaine-based
scalp block and laryngotracheal local anesthesia vs general
anesthesia only on pro-inflammatory cytokine concentra
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tions in patients with non-ruptured brain aneurysms under
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going elective open surgery.
Methods This parallel, randomized, controlled, open-label
trial was conducted at Clinical Hospital Center Zagreb be
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tween March 2019 and March 2020. At the beginning of an
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esthesia, lidocaine group received 40 mg of 2% lidocaine for
laryngotracheal topical anesthesia and 4 mg/kg for the scalp
block. Control group underwent general anesthesia only.
Plasma concentrations of IL-6, TNF-α, and IL-1β were mea
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sured before anesthesia (S0); at the incision (S1); at the end
of surgery (S2); 24 hours postoperatively (S3). Cerebrospinal
fluid (CSF) cytokine concentrations were measured at the in
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cision (L1) and the end of surgery (L2).
Results Forty patients (each group, 20) were randomized;
37 were left in the final analysis. IL-6 plasma concentrations
increased significantly compared with baseline at S3 in li
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docaine group, and at S2 and S3 in control group. In both
groups, changes in TNF-α and IL-1β were not significant. CSF
cytokine concentrations in lidocaine group did not change
significantly; in control group IL-6 and IL-1β were significantly
higher at L2 than at L1. CSF IL-6 in control group significantly
increased at L2, but TNF-α and IL-1β did not. No differences in
clinical outcome and complication rates were observed.
Conclusion Adjunctive lidocaine-based scalp block and lar
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yngotracheal local anesthesia might attenuate CSF IL-6 con
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centration increase in patients with brain aneurysm.
Ključne riječi
Hrčak ID:
278440
URI
Datum izdavanja:
26.8.2021.
Posjeta: 361 *