Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2017 Apr;45(2):439-450.
doi: 10.1177/0300060516665752. Epub 2017 Mar 7.

Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial

Affiliations
Clinical Trial

Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial

Banu O Can et al. J Int Med Res. 2017 Apr.

Abstract

Objective This study was performed to determine the effects of scalp blocks with bupivacaine versus levobupivacaine on the haemodynamic response during craniotomy and the efficacies and analgesic requirements of these drugs postoperatively. Methods This randomized, prospective, placebo-controlled, double-blind study included 90 patients (age, 18-85 years; American Society of Anesthesiologists physical status, I or II). The patients were randomly divided into three groups: those who received 20 mL of 0.5% bupivacaine (Group B, n = 30), 20 mL of 0.5% levobupivacaine (Group L, n = 30), or saline as a placebo (Group C, n = 30). Scalp blocks were performed 5 min before head pinning. The primary outcome was the mean arterial pressure (MAP), and the secondary outcomes were the heart rate (HR), visual analogue scale (VAS) scores, and additional intraoperative and postoperative drug use. Postoperative pain was evaluated using a 10-cm VAS. Results During head pinning and incision, the MAP and HR were significantly higher in Group C. The additional drug requirement for intraoperative hypertension and tachycardia was significantly higher in Group C. There were no significant differences in MAP, HR, or VAS scores between Groups B and L. Conclusion Both bupivacaine and levobupivacaine can be effectively and safely used for scalp blocks to control haemodynamic responses and postoperative pain.

Keywords: Anaesthesia; bupivacaine; haemodynamics; levobupivacaine; local anaesthesia.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Patient flow diagram. B, bupivacaine; L, levobupivacaine; C, control.
Figure 2.
Figure 2.
Mean arterial pressure in the three study groups at different time points. B, bupivacaine; L, levobupivacaine; C, control; MAP, mean arterial pressure.
Figure 3.
Figure 3.
Heart rate in the three study groups at different time points. B, bupivacaine; L, levobupivacaine; C, control; HR, heart rate.
Figure 4.
Figure 4.
Visual analogue scale scores of the conscious patients in the three study groups. *Significantly different at p < 0.05 compared with Groups B and L. B, bupivacaine; L, levobupivacaine; C, control. Figures over the bars denote the mean visual analogue scale scores. VAS visual analogue scale

References

    1. Shapiro HM, Wyte SR, Harris AB, et al. Acute intraoperative intracranial hypertension in neurosurgical patients: mechanical and pharmacologic factors. Anesthesiology 1972; 37: 399–405. - PubMed
    1. Doblar DD, Lim YC, Baykan N, et al. Preventing the hypertensive response to skull pin insertion: a comparison of four methods. J Neurosurg Anesth 1994; 6: 314–314.
    1. Pinosky ML, Fishman RL, Reeves ST, et al. The effect of bupivacaine skull block on the hemodynamic response to craniotomy. Anesth Analg 1996; 83: 1256–1261. - PubMed
    1. Nguyen A, Girard F, Boudreault D, et al. Scalp nerve blocks decrease the severity of pain after craniotomy. Anesth Analg 2001; 93: 1272–1276. - PubMed
    1. Ivani G, Borghi B, van Oven H. Levobupivacaine. Minerva Anestesiol 2001; 67(9 Suppl 1): 20–23. - PubMed

Publication types

MeSH terms

LinkOut - more resources