Effect of the local anesthetic agent bupivacaine prior to application of the skull-pin holder for craniotomies.
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.
Mathieu
David
D
Department of Neurosurgery, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada.
Beaudry
Mathieu
M
Martin
René
R
McLelland
Hans
H
Robert
Bruno
B
Kenny
Brendan
B
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
D000779:Anesthetics, Local; D002045:Bupivacaine