[Regional blockage for arterial blood pressure control during placement of head holder in neurosurgery].
OBJECTIVE
To achieve a hemodynamic stability in neurosurgery during placement of the craniostate, we compared the effects of blocking frontal and occipital nerves with supplementary doses of fentanyl with the effects observed after subcutaneous infiltration of craniostate fixation points.


METHODS
We studied 34 patients with intracranial masses programmed for craniotomy who were randomly allocated into three groups. Group I received fentanyl 3-5 micrograms/kg, 5 minutes before implantation of craniostate; Group II was treated with subcutaneous infiltration of mepivacaine 2% at craniostate fixation points; and Group III underwent blockade of frontal and occipital nerves. Mean arterial blood pressure was measured at baseline, immediately before craniostate placement, and during the maximal rise induced after placement of the craniostate.


RESULTS
Mean arterial blood after craniostate placement was significantly higher in Group I than in Group II (p < 0.01), and higher than in Group III (p < 0.05).


CONCLUSIONS
Blockade of frontal and occipital nerves is a useful method for maintaining hemodynamic stability during craniostate placement in neurosurgical patients.
Rubial
M
M
Servicio de Anestesiología-Reanimación y Terapia del Dolor, Hospital 12 de Octubre, Madrid.
Castells
M V
MV
Gargallo
M C
MC
Madrid
J L
JL
D000328:Adult; D001794:Blood Pressure; D003399:Craniotomy / Q000379:methods*; D005283:Fentanyl; D006257:Head / Q000294:innervation / Q000502:physiology / Q000601:surgery*; D006801:Humans; D008619:Mepivacaine; D008875:Middle Aged; D009407:Nerve Block
D008619:Mepivacaine; D005283:Fentanyl
Bloqueo regional para el control de la tensión arterial durante la colocación del craneostato en neurocirugía.