Scalp block for hemodynamic stability during neurosurgery

Background and Purpose: For elective neurosurgery procedures maintaining perioperative hemodynamic stability and optimal cerebral perfusion is of outmost importance. Beside numerous anesthetics techniques, risk of hemodynamic instability is still very high. Materials and Methods: We retrospectively analyzed perioperative values of heart rate and arterial blood pressure in 39 patients who underwent neurosurgery. We combined general anesthesia with scalp block. We blocked the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves with 0,5% chirocaine, including 5 μg/mL of epinephrine that was performed after general anesthesia induction, before pin placement. Heart rate and blood pressure values were measured before anesthesia induction, after induction, after pins placement, after craniotomy and at the end of surgery. Changes of heart rate and blood pressure values less than 20% after painful stimuli was considered as a good hemodynamic stability of applied anesthetic technique. Result: Scalp block was successfully performed in all patients without complications. Measured values of heart rate and blood pressure before and after anesthesia induction compered to values after painful stimuli werewithin the 20% change. Conclusion: Scalp block, combined with general anesthesia provide good hemodynamic stability during neurosurgery.