title: Effect of the local anesthetic agent bupivacaine prior to application of the skull-pin holder for craniotomies.
abstract: OBJECTIVE
  The authors conducted a double-blind prospective randomized study to determine whether infiltration of Mayfield skull-pin sites with 0.5% bupivacaine, compared with placebo, would prevent hemodynamic stimulation, thus allowing for a reduction in the quantity of anesthetic agents required.
  
  
  METHODS
  Thirty patients were randomized into two groups. There was a significant increase in blood pressure (mean systolic blood pressure 10 mm Hg, p = 0.003) in patients in the placebo group compared with that in patients in the bupivacaine group 1 minute after securing the head holder.
  
  
  CONCLUSIONS
  The local administration of bupivacaine for anesthetic purposes before skull-pin application may prevent potentially hazardous hemodynamic stimulation.
authors.affiliation: Department of Neurosurgery, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Mathieu
authors.forename: Mathieu
authors.initials: M
authors.lastname: Beaudry
authors.forename: René
authors.initials: R
authors.lastname: Martin
authors.forename: Hans
authors.initials: H
authors.lastname: McLelland
authors.forename: Bruno
authors.initials: B
authors.lastname: Robert
authors.forename: Brendan
authors.initials: B
authors.lastname: Kenny
mesh_terms: D000779:Anesthetics, Local / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D001858:Bone Nails; D001921:Brain / Q000098:blood supply / Q000187:drug effects; D002045:Bupivacaine / Q000494:pharmacology*; D003243:Consciousness / Q000187:drug effects; D003399:Craniotomy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011300:Preoperative Care; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine