الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 148 |  |  |
| | | from | 148 | | |
Abstract
Objectives:
Our aim is to compare skull block using 0.5% bupivacaine versus the use of
intravenous fentanyl during the maintenance phase of general anesthesia for
supratentorial craniotomies in geriatric patients as regarding hemodynamic stability,
effect on intracranial pressure (ICP), effect on plasma cortisol level as a part of
surgical stress response, recovery time and postoperative pain scores.
Patients & Methods:
Eighty patients were enrolled in the study. There were 43 male and 37 female
patients with a mean age of 70.15±2.11 years (ASA I, II, III) undergoing elective
supratentorial craniotomy. After induction of general anesthesia (GA), patients were
randomly assigned into two equal groups: Group B: patients had skull block using
bupivacaine (0.5%) and epinephrine (1:400,000); Group F: patients received fentanyl
2 μg/kg (during maintenance of GA).
Heart rate (HR) and mean arterial pressure (MAP) and plasma cortisol level were
recorded at baseline (before induction of anesthesia) , 1 minutes after intubation, 1
minute after skin incision, 1 minutes after dural incision, 1 minute after dural closure,
1 minute after skin closure, 1 minute after extubation. ICP was measured at the abovementioned
time points except at dura where ICP measured before dural incision. Time
to recovery from anesthesia was also recorded. Visual analogue scale (VAS) was
recorded every hour for the first 4 hours postoperatively.
Results:
MAP, HR, plasma cortisol level showed significant differences between-groups,
where group F had higher MAP, HR and plasma cortisol level than group B. Group B
had rapid recovery period and less postoperative pain scores than group F