Anesthesia: Essays and Researches

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 13  |  Issue : 4  |  Page : 625--630

Intravenous Fentanyl 4 μg per kg administered before scalp pin application is inferior to scalp block in preventing hemodynamic changes


S Arunashree1, Pradeep Hosagoudar2 
1 Department of Anesthesiology, Karwar Institute of Medical Sciences, Karwar, Karnataka, India
2 Department of Anesthesiology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India

Correspondence Address:
Pradeep Hosagoudar
Professor and HOD, Department of Anesthesiology, Kodagu Institute of Medical Sciences, Madikeri - 571 201, Karnataka
India

Background: Application of scalp pins for craniotomy surgeries is a noxious stimulus, causing tachycardia and hypertension, resulting in increased cerebral blood flow and elevated intracranial pressure, hence measures to attenuate this will have beneficial role. Aims: The aim is to compare the effectiveness of scalp block (SB) to 4 μg.kg-1 intravenous (i.v) fentanyl in attenuating hemodynamic response to scalp pin application in patients who underwent elective craniotomy under general anesthesia. Settings and Design: The study design involves prospective, randomized study conducted at Tertiary care center/hospital. Subjects and Methods: Forty-four American Society of Anesthesiologists physical status Classes l and II patients were randomly allocated into the following groups: Group-SB (n = 22) received SB using 0.25% injection bupivacaine and Group-F (n = 22) received 1 μg.kg-1 i.v fentanyl. Patient's heart rate (HR) and mean arterial pressure (MAP) were recorded from the application of pins till 60 min and rescue analgesic/anesthetic agents and their dosage were noted. Statistical analysis was performed comparing HR and MAP changes to application of scalp pins. Statistical Analysis: Software developed by the Centre for Disease Control, Atlanta, namely Epidemiological Information Package 2010 was used to derive statistical variables. Results: Patients were comparable in age, gender, hypertension as comorbidity, baseline HR, and MAP. Significant rise in HR was noted in Group-F till 20th min compared to Group-SB. MAP was high from application of pins till 60th min in Group-F compared to Group-SB. Requirement of rescue analgesics/anesthetics was high in Group-F compared to Group-SB. \Conclusion: SB effectively attenuates hemodynamic response to application of scalp pins in patients undergoing elective craniotomy and reduces requirement of rescue analgesic and/or anesthetics.


How to cite this article:
Arunashree S, Hosagoudar P. Intravenous Fentanyl 4 μg per kg administered before scalp pin application is inferior to scalp block in preventing hemodynamic changes.Anesth Essays Res 2019;13:625-630


How to cite this URL:
Arunashree S, Hosagoudar P. Intravenous Fentanyl 4 μg per kg administered before scalp pin application is inferior to scalp block in preventing hemodynamic changes. Anesth Essays Res [serial online] 2019 [cited 2020 Apr 2 ];13:625-630
Available from: http://www.aeronline.org/article.asp?issn=0259-1162;year=2019;volume=13;issue=4;spage=625;epage=630;aulast=Arunashree;type=0