The effect of scalp block with 0.25 % and 0.5 % Levobupivacaine on the hemodinamic response to head clamps and plasma interleukin-6 levels in craniotomies

The effect of scalp block with 0.25 % and 0.5 % Levobupivacaine on the hemodinamic response to head clamps and plasma interleukin-6 levels in craniotomiesIn our study, we aimed to determine the effect of scalp block with 0.25 % and 0.5% levobupivacaine on the hemodinamic response to head clamps and plasma interleukin-6 levels in patients that were going to undergo craniotomies.Forty patients with risk groups ASA I and II undergoing elective craniotomies were selected for the study. Blood samples were obtained to determine IL-6 levels before induction. The anesthesia protocol was standardized with sodium thiopental (until the BIS score went down to 60) and remiphentanyl (0.2 ?g/kg/min) was used for induction, followed endotracheal intubation after rocuronium (0.6 mg/kg) and remiphentanyl+sevoflurane were used during the continuation phase. Scalp block was administered with either a 0.25 % (20 mL) (Group I, n=20) or 0.5 % (20 mL) (Group II, n=20) concentration of levobupivacaine. After a sufficient waiting period, the administration of the head clamp was allowed.Prior to induction, control HR, SBP, DBP, MAP and BIS values were noted, and they were recorded again in the 1st minute of induction, 1 minute after intubation, 1 and 5 minutes after the scalp block, 1 and 5 minutes after the application of the head clamp and 1, 5, 10, 20, 30, 45, 60, 90, 120, 150, 180, 240 minutes after the incision. Two hours following the incision, blood sample was obtained for IL-6 levels. The amount of remiphentanyl used after intubation was recorded.There was no statistically significant difference within or between the two groups considering the hemodinamic parameters before surgery and after the application of the head clamp, or between the IL-6 levels before surgery and in the second hour after the incision.As a result, it was determined that there was no difference in the effect of scalp block with 0.25 % and 0.5 % levobupivacaine on the hemodinamic response to head clamps or on suppressing the plasma IL-6 levels. When the increase of side effects with increased dosage is taken into consideration, for analgesia and anesthesia in craniotomies, scalp blocks with levobupivacaine 0.25 % concentration has proven to be sufficient.Key words: craniotomy, scalp block, levobupivacaine, IL-6