• World Neurosurg · Jul 2023

    Sterile Silicone Studs (SSS) a non-pharmacological modality for prevention of hemodynamic response to skull pin insertion: A pilot study.

    • Rashi Sarna, Swati Patel, Nidhi Singh, Summit Bloria, Rajeev Chauhan, Shyam Meena, Ankur Luthra, Vishal Soni, Sandeep Mohindra, and Priya Thappa.
    • Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
    • World Neurosurg. 2023 Jul 8.

    ObjectiveApplication of surgical skull pins causes hemodynamic fluctuations in neurosurgical procedures. To reduce this response, we describe the use of a novel nonpharmacologic method in the form of medical-grade sterile silicone studs to cushion the pressure of the skull pin in the adult population. This study aimed to evaluate the use of conventionally used fentanyl and medical-grade sterile silicone studs for the prevention of hemodynamic response to skull pin insertion.MethodsA prospective randomized pilot study was conducted of 20 adult patients categorized as American Society of Anesthesiologists class I and II scheduled for elective craniotomy in November 2022 in a tertiary-care hospital in Chandigarh, India. Patients were randomized into 2 groups: fentanyl only (FO group; n = 10) and medical-grade silicone studs (SS group; n = 10). Heart rate and mean arterial pressure were recorded at the following intervals: T1, baseline; T2, before induction; T3, after intubation; T4, before skull pin insertion; T5, T6, T7, T8, T9, and T10 at 0, 1, 3, 4, and 5 minutes after skull pin insertion.ResultsDemographic data (e.g., sex, age, disease pathology) were comparable between the groups. Although changes in heart rate between the 2 groups were comparable, there was a statistically significant decrease in mean arterial pressure from 1 minute to 5 minutes after pinning in patients with silicone studs compared with patients who received only fentanyl.ConclusionsThe use of medical-grade silicone studs causes fewer hemodynamic fluctuations compared with fentanyl on skull pinning. Further studies with larger sample sizes are required to confirm the findings of this pilot study.Copyright © 2023 Elsevier Inc. All rights reserved.

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