Review article

Scalp block for hemodynamic stability during neurosurgery

DINKO TONKOVIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
VASILIJE STAMBOLIJA ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
MARIN LOZIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
PETAR MARTINOVIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
DANIJELA BANDIĆ PAVLOVIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ANTE SEKULIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ROBERT BARONICA ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
MLADEN PERIĆ ; Department of Anesthesia, Reanimatology and Intensive Care, Clinical center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia

Abstract

Background and Purpose: For elective neurosurgery procedures maintaining perioperative hemodynamic stability and optimal cerebral perfusion is of outmost importance. Beside numerous anesthetics techniques, risk of hemodynamic instability is still very high.

Materials and Methods: We retrospectively analyzed perioperative
values of heart rate and arterial blood pressure in 39 patients who underwent neurosurgery. We combined general anesthesia with scalp block. We blocked the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves with 0,5% chirocaine, including 5 μg/mL of epinephrine that was performed after general anesthesia
induction, before pin placement. Heart rate and blood pressure values
were measured before anesthesia induction, after induction, after pins placement, after craniotomy and at the end of surgery. Changes of heart rate and blood pressure values less than 20% after painful stimuli was considered as a good hemodynamic stability of applied anesthetic technique.

Result: Scalp block was successfully performed in all patients without
complications. Measured values of heart rate and blood pressure before and after anesthesia induction compered to values after painful stimuli werewithin the 20% change.

Conclusion: Scalp block, combined with general anesthesia provide good hemodynamic stability during neurosurgery.

Keywords

scalp block; neurosurgery; hemodynamics

Hrčak ID:

142914

URI

https://hrcak.srce.hr/142914

Publication date:

10.6.2015.

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