The Hemodynamic Effect of Nerve Block by Cranial Pinning in Brain Surgery Patients

Kim, Bong Il; Park, Chan Hong; Choi, Byung Ki

Abstract

BACKGROUND: It is already known that the cranial pinning causes a sudden increment of blood pressure and heart rate which is harmful especially in brain surgery patient. These changes may be reduced by local infiltration at the sites of cranial pinning. This study was designed to investigate the hemodynamic effects of nerve block by cranial pinning and compare them with the effects of local infiltration at the pinning site.
METHODS
Forty patients of brain surgery with cranial pinning were involved. After general anesthesia with isoflurane and 50% N2O, they were divided into 2 groups randomly: the control group (n = 20), had local infiltration at each pinning site with 1% lidocaine 2 ml, and the study group (n = 20), had nerve block of the supraorbital, and supratrochlear, and postauricular branches of the great auricular nerve with lidocaine 2 ml, the auriculotemporal nerve with lidocaine 2.5 ml, and the greater and lesser occipital nerves with lidocaine 2.5 ml. The hemodynamic variables(systolic, diastolic, mean blood pressure, and heart rate) were measured at the 3 different points just before cranial pinning, and 1 min and 5 min after cranial pinning.
RESULTS
The values of hemodynamic variables at 1 min after cranial pinning increased in both groups when compared with just before cranial pinning, but there was no difference between the two groups. The increased values at 1 min were not high clinically, and returned to the levels recorded before cranial pinning by the 5 min recording time in both groups.
CONCLUSION
From these results, we concluded that nerve block could also reduced the harmful hemodynamic effect of cranial pinning.