A comparsion between intravenous dexmedetomidine and bupivacaine scalp block in attenuating the hemodynamic response to skull pin head holder application in neurosurgical patients

A comparsion between intravenous dexmedetomidine and bupivacaine scalp block in attenuating the hemodynamic response to skull pin head holder application in neurosurgical patients
CTRI/2022/04/041989 [Registered on: 20/04/2022] Trial Registered Prospectively
A comparison between intravenous dexmedetomidine and bupivacaine scalp block in attenuating hemodynamic response to skull pin application in neurosurgical patients
Introduction:
The skull pin application lead to intense noxious stimuli and increase in HR, MAP, plasma catecholamine and CBF even when the patients are under general anaesthesia.
Aim and objectives:
To compare the efficacy of intravenous Dexmedetomidine infusion with 0.5% Bupivacaine scalp block in attenuating the hemodynamic response, to the skull pin head holder application in neurosurgical patients.
Methods:
Sixty patients of ASA I & II posted for elective craniotomy were taken in the study,
Group S(30) –Patients received scalp block with injection Bupivacaine 0.5% 30ml prior pin application
Group D(30)-Patients received intravenous Dexmedetomidine 0.5mcg/kg i.v loading dose and 0.25mcg/kg/hr
Results:
Demographic parameters was comparable between two groups . Heart rate (HR) variation between Group S and Group D was comparable. Dexmedetomidine after intubation did not completely attenuate the cardiovascular response.The SBP & DBP & MAP between two groups was comparable Single bolus administration of injection Fentanyl 1mcg/kg was needed in 4/7 patients and increased inhalational concentration was needed in 1/7 patients in Group S, both methods were needed in 2/7 patients in Group S. The adverse hemodynamic events was comparable. The 0.5% Bupivacaine (Rs 85)was cost effective when compared with the Dexmedetomidine 50mcg/ml(Rs 170)
Conclusion
We conclude that the Scalp block with 0.5% Bupivacaine was better than Dexmedetomidine infusion in attenuating the hemodynamic response to skull pin head holder application in neurosurgical patients.