Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1391
11
1
gregorian
2013
2
1
27
1
online
1
fulltext
en
Impact of subcutaneous infiltration of 0.5% bupivacaine on postoperative C-reactive protein serum titer after craniotomy surgery
Anesthesia
Anesthesia
Original Research
Original Research
<font size="3" face="Times New Roman"> </font><font face="Calibri"><font size="3"><b>Background:</b> Tissue injuries may provoke neuro-hormonal response which in turn may lead to release of inflammatory cytokines. We hypothesize that block of afferent sensory pathways by infiltration of 0.5% bupivacaine in the scalp may decrease neuro-hormonal response in the neurosurgical patient.<p></p></font></font><font size="3" face="Times New Roman"> </font><p style="TEXT-ALIGN: justify MARGIN: 0in 0in 10pt" class="MsoNormal"><font face="Calibri"><font size="3"><b>Methods:</b> After obtaining informed consent, forty ASA physical statuses I, II, or III patients between the ages of 18 and 65 years were enrolled randomly into two equal groups to receive either 20 ml of 0.5% bupivacaine (group A) or 20 ml of 0.9% normal saline as a placebo (group B) in the site of pin insertion and scalp incision. As the primary outcome we checked serum C-reactive protein (CRP) levels before implementation of noxious stimulus, 24h, and 48h after the end of surgery to compare these values between groups. In addition, mean arterial pressure (MAP) and heart rate (HR) were checked at baseline (after the induction of anesthesia), one minute after pin fixation and 5, 10, and 15 minute after skin incision and the recorded values were compared between groups.<p></p></font></font></p><font size="3" face="Times New Roman"> </font><font face="Calibri"><font size="3"><b>Results:</b> No significant difference was found between serum CRP levels of the two groups. Comparison of mean HR between groups shows no significant difference. The mean of MAP was significantly lower in the group A in comparison with the group B (P < 0.001).<p></p></font></font><font size="3" face="Times New Roman"> </font><p style="TEXT-ALIGN: justify MARGIN: 0in 0in 10pt" class="MsoNormal"><font size="3"><font face="Calibri"><b>Conclusion:</b> The results of this study confirm that 0.5% bupivacaine scalp infiltration before skull-pin holder fixation and skin incision could not decrease post-operative C-reactive protein level.<p></p></font></font></p><font size="3" face="Times New Roman"> </font>
Craniotomy, C-reactive protein, Neuro-hormonal response, Inflammatory response.
1
6
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-560&slc_lang=en&sid=1
Reza
Shariat Moharari
moharari@tums.ac.ir
20031947532846007357
20031947532846007357
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Saber
Amin Zade
aminzadehsaber@yahoo.com
20031947532846007358
20031947532846007358
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Farhad
Etezadi
etezadi@tums.ac.ir
20031947532846007359
20031947532846007359
Yes
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Atabak
Najafi
nadjafia@tums.ac.ir
20031947532846007360
20031947532846007360
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Mohammad Reza
Khajavi
khajavim@tums.ac.ir
20031947532846007361
20031947532846007361
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Mohammad
Shirani Bidabadi
drmshirani@yahoo.com
20031947532846007362
20031947532846007362
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
Hadieh Moradi
Tabriz
hmoradi@razi.tums.ac.ir
20031947532846007363
20031947532846007363
No
Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.