Hemodynamic outcomes of adult patients on scalp block using ropivacaine and lidocaine: retrospective cohort study
Background. Hemodynamic instability can occur with the pain from scalp incision to brain retraction during cranial neurosurgery.
Objective. To determine the hemodynamic outcomes of patients who received ropivacaine plus lidocaine scalp block.
Design. Retrospective cohort study.
Setting. Southern Philippines Medical Center, Davao City.
Participants. 44 patients given scalp block for cranial neurosurgery.
Main outcome measures. Heart rate (HR), mean arterial pressure (MAP), and frequencies of tachycardia, hypertension, bradycardia, and hypotension from the time of scalp block administration to 15 minutes after scalp incision (observation period).
Main results. There were 31 (70.45%) male and 13 (20.55%) female patients in this study. The patients’ mean age was 42.97 ± 17.33 years. Mean values of MAP from 5 minutes before incision to 15 minutes after incision all significantly differed from mean baseline MAP. There were no significant changes in mean HR within the observation period (p=0.2446). Among the patients, 3/44 (6.82%) had at least one episode of hypertension, 7/44 (15.91%) had at least one episode of tachycardia, 8/44 (18.18%) had at least one episode of bradycardia, and 27/44 (61.36%) had at least one episode of hypotension during the observation period.
Conclusion. The mean MAP of patients in this study significantly decreased from baseline starting from 5 minutes prior to scalp incision to 15 minutes after scalp incision. Many patients had at least one episode of hypotension, while fewer patients experienced at least one episode of hypertension, tachycardia or bradycardia.
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