Abstract
Objective The aim of this placebo controlled study was to investigate the oxidative, haemodynamic and analgesic effects of local lidocaine infiltration alone or intravenous (iv) fentanyl injection or combination of lidocaine and iv fentanyl during head fixation in a 3-pin headrest in patients undergoing elective craniotomy.
Design Double blind, randomised, placebo controlled study.
Setting Gaziantep University Medical Faculty, Department of Anesthesiology and Reanimation.
Methods Eighty patients were randomly assigned to 1 of 4 groups. The patients received 1 mg/kg of lidocaine (2%) for scalp infiltration (group L) (n=20), or 1 μg/kg of iv fentanyl (group F) (n=20), or 1 mg/kg of lidocaine 2% and 1 μg/kg of fentanyl (group FL) (n=20), or placebo (group P) (n=20) 5 minutes before pin fixation (PF). Following standard anesthesia; basal, pre and post fixational haemodynamic data were recorded. The blood samples were taken for the oxidants’-antioxidants’ evaluation after and before PF.
Results The TAS (Total antioxidants) levels after PF among the groups were arranged in order like FL>F>L> P (p<0.05). The MAP (mean arterial blood pressure) after PF was higher than the MAP before PF in group L and P (p<0.05). The MAP after PF was lower than MAP before PF in group F (p>0.05) and FL(p<0.05).
Conclusion The combination of fentanyl and lidocaine before PF is useful in preventing the severe haemodynamic answers to painful stimulus such as pin fixation and increasing TAS in the postfixational period during craniotomy in adults.
- Received August 30, 2009.
- Revision received January 17, 2010.
- Revision received October 26, 2010.
- Accepted November 1, 2010.
