EFFECTS OF 0.5% ROPIVACAINE SCALP PIN AND PREINCISIONAL INFILTRATION WITH GENERAL ANESTHESIA ON HEMODYNAMIC RESPONSE IN CRANIOTOMY

Kinna G. Shah*, Leena Patel, Vidhi kantesaria and B. M Patel

ABSTRACT

Aim: To compare the efficacy of 0.5% ropivacaine local infiltration in attenuating the hemodynamic response to the scalp pin and incision application in neurosurgical patients. Method: One hundred patients posted for elective craniotomy were randomly allocated into 2 groups of 50 patients each. Group R received 0.5% Ropivacaine (20 cc of 5 mg/ml) and Group L infiltrated with 1% Lignocaine with adrenaline (20 cc). Recording of the haemodynamic data was done at following times: pre operative, intubation, pre infiltration, post pinning, and pre incision, post incision, 5 min post incision and 10 min post incision. Results: No significant rise in pulse rate responses occurred during any event in patients receiving ropivacaine scalp pin and preincisional infiltration (P < 0.05). There was rise of systolic and diastolic blood pressure at post incision but it was not significant level It should be deleted in group R. Supplemental propofol required to control the hemodynamic variation at post incision was 48% patients in Group L and 12% of group R. Brain relaxation was very good in 92% of group R, 60% in group L. Conclusion: Infiltration at Scalp pin and pre-incisional with 0.5% ropivacaine is very effective, safe and superior to lignocaine hydrochloride 1 % with adrenaline in attenuating the hemodynamic response in craniotomy. As there was no difference in blood loss in both groups, supports the local vasoconstriction effect of 0.5% ropivacaine.

Keywords: Scalp, infiltration, stress response, ropivacaine.