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首页> 外文期刊>Surgical Neurology International >How effective is the local anesthetic infiltration of pin sites prior to application of head clamps: A prospective observational cohort study of hemodynamic response in patients undergoing elective craniotomy
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How effective is the local anesthetic infiltration of pin sites prior to application of head clamps: A prospective observational cohort study of hemodynamic response in patients undergoing elective craniotomy

机译：应用头部夹钳之前，局部麻醉药渗入针部位的效果如何：前瞻性队列研究对择期开颅手术患者的血流动力学反应

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Background: Use of Mayfield clamps is associated with potentially hazardous hemodynamic effects. Use of local anesthetic infiltration has yielded varying results in blunting of this response. The authors′ objective was to study the effect of lidocaine with adrenaline infiltration at Mayfield pin sites on hemodynamic response in comparison with no intervention. Methods: This was a prospective cohort study conducted at a tertiary care center from January 2012 to July 2012. Patents undergoing elective craniotomies over the study period were included and divided in two groups, Group A received lidocaine infiltration of the pin sites prior to insertion, while Group B did not. Hemodynamic response to pin application was then studied at various intervals. Results: A total of 30 patients were enrolled in each group. The baseline mean arterial pressure (MAP) and heart rate prior to pin placement in Groups A and B were comparable (P = 0.985 and 0.313). The MAP at 60 seconds after application of skull pins was significantly different in the two groups; 86.13 (±9.73) mmHg versus 104.03 (±12.95) mmHg (P P = 0.585). The mean heart rate measured at 60 seconds after skull pin insertion in Group A was 78.23 (±7.19)/min while in Group B, it was 103.07 (±6.98)/min, the difference being statistically significant (P Conclusion: Hemodynamic changes due to the application of Mayfield clamps during elective craniotomies can be effectively prevented by prior lidocaine with adrenaline infiltration of the pin insertion sites.
机译：背景：使用Mayfield钳夹会带来潜在的危险的血液动力学效应。局部麻醉药浸润的使用在减弱这种反应方面产生了不同的结果。作者的目的是研究与不进行干预相比，利多卡因与梅菲尔德针部位肾上腺素的浸润对血液动力学反应的影响。方法：这是一项前瞻性队列研究，于2012年1月至2012年7月在三级护理中心进行。研究期间接受选择性颅骨开颅手术的专利被分为两组，A组在插入前接受了利多卡因针销的浸润，而B组则没有。然后在不同的时间间隔研究对针施加的血流动力学响应。结果：每组共招募30名患者。在A组和B组中放置针之前，基线平均动脉压（MAP）和心率是可比较的（P = 0.985和0.313）。两组应用颅骨针后60秒时的MAP显着不同; 86.13（±9.73）mmHg与104.03（±12.95）mmHg（P P = 0.585）。 A组在颅骨钉插入后60秒测得的平均心率是78.23（±7.19）/ min，而B组是103.07（±6.98）/ min，差异具有统计学意义（P结论：血流动力学变化是由于事先利多卡因对销钉插入部位的肾上腺素浸润可以有效地防止选择性开颅手术期间应用Mayfield钳。

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