Key result
Scalp block combined with general anesthesia during craniotomy inhibited hypertension due to surgical stress and avoided hypotension due to a high volume of anesthetic.
Case Report (n=1)
No
Scalp block combined with general anesthesia may help maintain hemodynamic stability in patients with severe vascular comorbidities undergoing neurosurgery.
76歳の男性．脳梗塞に対し左浅側頭動脈-中大脳動脈吻合術が予定された．遠位弓部に径56mmの胸部大動脈瘤を指摘されたが，胸部手術により脳梗塞の増悪が予想されるため，頭部手術が優先された．麻酔管理中の血圧変動を抑える目的で，scalp block（頭皮ブロック）を併用した全身麻酔で管理した．超音波ガイド下に左大後頭神経・左小後頭神経・左大耳介神経ブロックを行った．さらに，全身麻酔導入後に左右眼窩上神経および滑車上神経・左頬骨側頭神経・左耳介側頭神経ブロックをランドマーク法で行った．Scalp blockの併用により，手術侵襲による血圧上昇の抑制と同時に，高用量の麻酔薬による血圧低下も回避することが可能であった．
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KURIHARA et al. (2016) conducted a case report in Thoracic aortic aneurysm and cerebral infarction (n=1). Scalp block combined with general anesthesia was evaluated on Blood pressure control. Scalp block combined with general anesthesia during craniotomy inhibited hypertension due to surgical stress and avoided hypotension due to a high volume of anesthetic.
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