Document Detail


Lighter general anesthesia causes less decrease in arterial pressure induced by epinephrine scalp infiltration during neurosurgery.
MedLine Citation:
PMID:  17893579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Scalp infiltration with epinephrine-containing lidocaine solution can elicit significant hypotension before craniotomy under general anesthesia. A prospective randomized controlled study was designed to observe whether a lighter depth of general anesthesia could prevent the unintentional hypotension induced by the epinephrine scalp infiltration during neurosurgery or not. Fifty patients undergoing scheduled neurosurgery involving craniotomy were randomly allocated into 2 groups. After anesthesia induction, anesthesia was maintained with propofol 2 mug/mL and rimifentanil 2 ng/mL by target-controlled infusion in group 1, and propofol 4 microg/mL and rimifentanil 4 ng/mL in group 2 (control group), respectively. All the patients received epinephrine scalp infiltration with 1% lidocaine 16 mL containing epinephrine 5 microg/mL. Mean arterial pressure (MAP) and heart rate were recorded at 30-second interval from the baseline to 5 minutes after the beginning of local infiltration. Bispectral index readings indicated group 1 had the lighter general anesthesia than group 2 (P<0.05). MAP was higher (P<0.05) and heart rate was lower (P<0.05) at 1.5 minutes time point in group 1 than group 2. The mean percentage of maximal decrease in MAP was group 1 (13%) <group 2 (24%) (P<0.05). The mean percentage of maximal increase in MAP was group 1 (10%)> group 2 (4%) without significant difference (P>0.05). The results implied that keeping a lighter general anesthesia caused less decrease in arterial blood pressure and was a relative effective method to prevent hypotension episode induced by epinephrine scalp infiltration.
Authors:
Jian-jun Yang; Jin Liu; Man-lin Duan; Zhi-qiang Zhou; Wei-yan Li; Jian-guo Xu
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  19     ISSN:  0898-4921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-25     Completed Date:  2007-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, PR China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Androstanols
Anesthesia, General*
Anesthesia, Intravenous*
Anesthetics, Intravenous / administration & dosage*
Anesthetics, Local / administration & dosage,  adverse effects
Blood Pressure / drug effects*
Carbon Dioxide / blood
Epinephrine / adverse effects*,  pharmacokinetics*
Female
Heart Rate / drug effects
Humans
Lidocaine / administration & dosage,  adverse effects
Male
Midazolam / administration & dosage
Middle Aged
Neuromuscular Nondepolarizing Agents
Neurosurgical Procedures*
Propofol / administration & dosage
Scalp / metabolism*
Vasoconstrictor Agents / adverse effects*,  pharmacokinetics
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 0/Neuromuscular Nondepolarizing Agents; 0/Vasoconstrictor Agents; 124-38-9/Carbon Dioxide; 137-58-6/Lidocaine; 143558-00-3/rocuronium; 2078-54-8/Propofol; 51-43-4/Epinephrine; 59467-70-8/Midazolam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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