• Ayse Mizrak, Ibrahim Erkutlu, Mehmet Alptekin, Elzem Sen, Murat Geyik, Abdulvahab Gok, and Unsal Oner.
• Department of Anesthesiology and Reanimation, Sahinbey, Gaziantep, Turkey. aysemizrak@mynet.com
• Clin Med Res. 2011 Jun 1;9(2):82-7.

ObjectiveThe aim of this study was to investigate the oxidative, hemodynamic, and analgesic effects of local lidocaine infiltration, or intravenous (IV) fentanyl injection, or a combination of lidocaine and IV fentanyl during head fixation in a 3-pin headrest in patients undergoing elective craniotomy.DesignDouble-blind, randomized, placebo-controlled study.SettingGaziantep University Medical Faculty, Department of Anesthesiology and Reanimation.MethodsEighty patients were randomly assigned to one of four groups. Five minutes before pin fixation, patients in group L received 1 mg/kg of lidocaine 2% for scalp infiltration (n=20), group F received 1 μg/kg of IV fentanyl (n=20), group FL received 1 mg/kg of lidocaine 2% and 1 μg/kg of fentanyl (n=20), and group P received a placebo (n=20). Following standard anesthesia, basal, pre- and post-fixational hemodynamic data were recorded. Blood samples were taken for evaluation of oxidant and antioxidant levels before and after pin fixation.ResultsThe total antioxidant levels after pin fixation were highest in group FL followed by group F, then group L and finally group P (ie, FL>F>L>P) (P<0.05). The mean arterial blood pressure (MAP) after pin fixation was higher than the MAP before pin fixation in groups L and P (P<0.05), but was lower in groups F and FL (P<0.05).ConclusionThe combination of fentanyl and lidocaine before pin fixation is useful in preventing severe hemodynamic response to pain stimuli, such as pin fixation, and in increasing total antioxidant levels in the post-fixational period during craniotomy in adults.

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