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Mushtaq, Khalida
- A Randomized Controlled Study to Compare the Effectiveness of Intravenous Dexmedetomidine with Placebo to Attenuate the Haemodynamic and Neuroendocrine Responses to Fixation of Skull Pin Head Holder for Craniotomy
Authors
1 Department of Anaesthesiology and Critical care, Government Medical College, Jammu, Jammu and Kashmir, IN
2 Department of Neuroanaesthesiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
3 Department of Anaesthesiology and Critical Care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
4 Department of Anaesthesiology and Critical care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
5 Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IN
Source
Northern Journal of ISA, Vol 1, No 1 (2016), Pagination: 16-23Abstract
The stress response to an intense painful surgical stimulus is characterized by activation of the sympathetic nervous system and an increased secretion of the pituitary hormones. The ability of the alpha agonist dexmedetomidine was tested to decrease heart rate, arterial blood pressure, and neuroendocrinal responses to skull-pin head-holder. 60 patients undergoing craniotomy were randomly distributed to receive either saline (P group) or Dexmedetomidine (D group). The placebo group received saline, whereas the treatment group (D group) received a single bolus dose of dexmedetomidine (1 microgram/kg) intravenously over 10 minutes before induction of anaesthesia. Haemodynamic parameters as heart rate, arterial blood pressure, and serial levels of cortisol, prolactin, insulin, and blood glucose were measured. Both the groups were comparable with respect to age, weight, sex and duration of surgery. The arterial blood pressure and heart rate was found to be lower in the dexmedetomidine group when compared with the placebo group (P<0.05). In both groups there was an increase in the plasma cortisol, prolactin, and blood glucose levels. However, the values were significantly higher in the placebo group compared with the dexmedetomidine group (P<0.05). The insulin levels were not significantly changed because of the administration of the dexmedetomidine. Our study demonstrates that, a single bolus dose of dexmedetomidine before induction of anesthesia attenuated the hemodynamic and neuroendocrinal responses to skull-pin insertion in patients undergoing craniotomy.
Keywords
Craniotomy, Hemodynamic Effects, Neuroendocrine Response, Stress Response.Full Text
References
- Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000;85:109–17.
- Shapiro HM, Wyte SR, Harris AB, Galindo A. Acute intraoperative intracranial hypertension in neurosurgical Patients: Mechanical and pharmacologic factors. Anesthesiology 1972;37:399–405.
- Paulson OB, Strandgaard S, Edvinsson L. Cerebral autoregulation. Cerebrovascular and brain Metabolism Reviews 1990;2:161–92.
- Shapiro HM, Drummond JC. Neurosurgical anesthesia. In: Miller RD, Cuchiara RF, Miller ED, Reves JG, Roizen MF, Savarese JJ, editors. Anesthesia. 4th Ed. New York: Churchill Livingstone; 1994. p. 1897– 946.
- Scheinin H, Jaakola ML, Sjovall S, Ali-Melkkila T, Kaukinen S, Turunen J, et al. Intramuscular dexmedetomidine as premedication for general anesthesia. A comparative multicenter study. Anesthesiology 1993;78:1065–75.
- Venn RM, Bradshaw CJ, Spencer R, Brealey D, Caudwell E, Naughton C, et al. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit. Anaesthesia 1999;54:1136–42.
- Basali A, Mascha EJ, Kalfas I, Schubert A. Relation between perioperative hypertension and intracranial hemorrhage after craniotomy. Anesthesiology 2000;93:48–54.
- Levin R, Hesselvik JF, Kourtopoulos H, Vavruch L. Local anesthesia prevents hypertension following application of the Mayfield skull-pin head holder. Acta Anaesthesiol Scand 1989;33:277–9.
- Hillman DR, Rung GW, Thompson WR, Davis NJ. The effect of bupivacaine scalp infiltration on the hemodynamic response to craniotomy under general anesthesia. Anesthesiology 1987;67:1001–3.
- Colley PS, Dunn R. Prevention of blood pressure response to skull-pin head holder by local anesthesia. Anesth Analg 1979;58:241–3.
- Shapiro HM. Intracranial hypertension: Therapeutic and anaesthetic considerations. Anesthesiology 1975;43:445–71.
- Roy WL, Edelist G, Gilbert B. Myocardial ischemia during non-cardiac surgical procedures in patients with coronary arterial disease. Anesthesiology 1979;51:393–7.
- Fox EJ, Sklar GS, Hill CH, Raymond V, King BD. Complications related to the pressure response to endotracheal intubation. Anesthesiology 1977;47:524–5.
- Maze M, Virtanen R, Daunt D, Banks SJ, Stover EP, Feldman D. Effects of dexmedetomidine, a novel imidazole sedative-anesthetic agent, on adrenal steroidogenesis: In vivo and in vitro studies. Anesth Analg. 1991;73:204–8.
- Talke P, Richardson CA, Scheinin M, Fisher DM. Postoperative pharmacokinetics and sympatholytic effects of dexmedetomidine. Anesth Analg 1997; 85:1136–4.
- Bekker A, Sturaitis M, Bloom M, Moric M, Golfinos J, Parker E, et al. The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy. Anesth Analg. 2008;107:1340–7.
- Cormack JR, Orme RM, Costello TG. The role of α2-agonists in neurosurgery. J Clin Neurosci 2005;12:375–8.
- Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes MD, Lee L, et al. Dexmedetomidine sedation during awake craniotomy for seizure resection: Effects on electrocorticography. J Neurosurg Anesthesiol 2007;19:38–44.
- Uyar AS, Yagmurdur H, Fidan Y, Topkaya C, Basar H. Dexmedetomidine attenuates the hemodynamic and neuroendocrinal responses to skull-pin head-holder application during craniotomy. J Neurosurg Anesthesiol. 2008;20:174–9.
- Tanskanen PE, Kytta JV, Randell TT, Aantaa RE. Dexmeditomidine as an anaesthetic adjuvant in patients undergoing intracranial tumour surgery: A double-blind, randomized and placebo-controlled study. Br J Anaesth. 2006;97:658–65.
- Turan G, Ozgultekin A, Turan C, Dincer E, Yuksel G. Advantageous effects of dexmedetomidine on haemodynamic and recovery responses during extubation for intracranial surgery. Eur J Anaesthesiol. 2008;25:816–20.
- Soliman RN, Hassan AR, Rashwan AM, Omar AM: Prospective, randomized controlled study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anesthesia. Middle East J Anesthesiol 2011;21:23–43.
- Mukhtar AM, Obayah EM, Hassona AM. The use of dexmedetomidine in pediatric cardiac surgery. Anesth Analg 2006;103:52–6.