Effect of Scalp Nerve Block on Stress Status and Cerebral Blood Flow in Patients with Hypertensive Intracerebral Hemorrhage during Stereotactic Intracranial Hematoma Removal
Abstract：【Objective】To compare the effect of stereotactic intracranial hematoma removal with SNB anesthesia and local infiltration anesthesia on stress state and cerebral blood flow index in patients with hypertensive intracerebral hemorrhage.【Methods】The clinical data of 102 patients with hypertensive intracerebral hemorrhage who underwent stereotactic evacuation of intracranial hematoma from June 2017 to December 2018 were analyzed retrospectively. According to the different anesthesia methods, they were divided into block anesthesia group and infiltration anesthesia group, 51 cases each; the changes of serum fasting blood glucose (FPG), cortisol (Cor) level and arterial partial pressure of oxygen (PaO2), arterial partial pressure of oxygen (PaCO2), arterial oxygen saturation (SaO2) and mean arterial pressure (MAP) were compared between the two groups when entering the chamber (T0), at scalp incision (T1), at craniotomy (T2) and at suture (T3). 【Results】 There was no significant difference between PaO2, PaCO2, SaO2 and MAP at T0, T1, T2, T3 in the block anesthesia group (P>0.05). In the invasive anesthesia group, PaO2 was lower than T0 at T1, T2, T3, and PaCO2, MAP was higher than T0, and the difference was statistically significant (P<0.05); the PaO2 was lower in the invasive anesthesia group T1, T2, T3 than in the block anesthesia group, and PaCO2, MAP was higher than in the block anesthesia group, the difference was statistically significant (P<0.05). There was no significant difference in serum FPG and Cor levels in the block anesthesia group T0, T1, T2, T3(P>0.05). The average water of FPG and Cor in the invasive anesthesia group T1, T2, T3 was higher than that of T0, and all were higher than those in the simultaneous point block anesthesia group, the difference was statistically significant (P<0.05).【Conclusion】 Stereotactic evacuation of intracranial hematoma with scalp nerve block anesthesia for patients with hypertensive cerebral hemorrhageare has little effect on cerebral blood flow and light stress response with much more safety, and is better than local infiltration anesthesia.
2020, Vol. 37 
