A randomized control trial comparing the efficacy of intravenous Dexmedetomidine infusion versus scalp block with 0.5% Levobupivacaine and fentanyl to attenuate the hemodynamic response to skull pin insertion in Craniotomies

Abstract

Introduction: This study compares the efficacy of intravenous dexmedetomidine, fentanyl, and 0.5% levobupivacaine scalp block in attenuating the hemodynamic response to skull pin insertion in craniotomies. The aim is to improve patient outcomes and safety in neurosurgery by refining perioperative management strategies. Aims: The study investigates the efficacy of intravenous dexmedetomidine infusion and scalp block with fentanyl and 0.5% levobupivacaine in attenuating the hemodynamic response to skull pin insertion in craniotomies. Methodology: The study at Krishna Institute of Medical Sciences involved 80 patients aged 18-65 for elective and emergency craniotomies with skull pins under general anesthesia, measuring parameters at baseline, induction, and pinning. Results: The study found no significant differences in age, sex, height, weight, ASA status, MAP measurements, bradycardia, hypotension, or rescue medication requirements between two groups. Discussion: The study compared anesthesia methods in patients with varying heights, weights, and ASA statuses, finding dexmedetomidine effective in maintaining oxygenation, lower heart rates, and attenuating hemodynamic changes during skull pin insertion. Conclusion: The study found scalp block with fentanyl-levobupivacaine and IV dexmedetomidine effectively reduces skull pin insertion hemodynamic response, but provides better analgesia, requiring caution due to potential adverse effects.