European Journal of Molecular & Clinical Medicine

Abstract

Aim: to find the role of caudal epidural steroid injections in the management of chronic low backache.
Material and methods: This prospective observational study was carried out in the Background and Aims: Scalp blocks combined with general anaesthesiaprovides stable perioperative haemodynamics and analgesia besides reducing pin and incision response.Maintaining appropriate depth of anesthesia by starting propofol infusionalso provides stable hemodynamics. Therefore,we have studied and compared the effects of scalp nerve block VS propofol infusion during skull pinning / skin incision while performing craniotomies and also measured the postoperative pain using VAS scores.
Material and Methods:Forty ASA I, II, III patients scheduled for elective craniotomies, were enrolled in this prospective, randomised, double blind study. Group A scalp block was given (0.5% bupivacaine) and in Group B propofol infusion was started(0.5-1mg/kg/hour).Bilateral block was given immediately after induction.Propofol infusion was started and titrated according to the haemodynamics. Heart rate and blood pressure were recorded before induction, after incision/pinning and till 2 hours after extubation. Fentanyl 1microgram/kg was given if a 20% increase in heart rate or blood pressure is there.Post operatively hemodynamics and VAS score was recorded.If VAS score is above 3 rescue analgesia was given.Any intraoperative complications were noted.All analysis was carried out by using SPSS software version 21. Results:There were significant increase in heart rate and blood pressure during head pinning/incision in the propofol infusion group as compared to scalp block group.
Conclusion:We conclude that scalp block, blunts the hemodynamic response to skull pinning/skin incision,  decrease the incidence of postoperative pain ,and the need of rescue analgesics(opiods,NSAIDS) ,hence should be considered in conjunction with general anesthesia for craniotomy.