Comparison of the Hemodynamic Indices during Skull-Pin Head-Holder Insertion in Neurosurgeries in Two Groups Receiving Dexmedetomidine and Midazolam

Abstract

Background: This study aimed to compare the hemodynamic effects of dexmedetomidine and midazolam in neurosurgery candidates who underwent skull-pin head-holder insertion. Methods: In this randomized clinical trial study, 68 patients candidate for neurosurgery were divided into two groups receiving dexmedetomidine or midazolam. After induction of anesthesia, the patients received dexmedetomidine or midazolam based on the group they allocated to. Ten minutes after induction of anesthesia, the surgeon was allowed to insert the skull-pin head-holder. Hemodynamic variables were recorded before and during the surgery. Findings: Among 68 studied patients, there was significant difference between the groups regarding systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.002), mean blood pressure (P = 0.450), and heart rate (P = 0.003). Systolic, diastolic, and mean blood pressure in the midazolam group was significantly higher at first, second, and third minute after the insertion of the skull-pin head-holder in comparison with the dexmedetomidine group. Moreover, the heart rate was significantly higher in the midazolam group before inserting the skull-pin head-holder up to 3 minutes after the insertion in comparison with the dexmedetomidine group (P < 0.050). Conclusion: Compared with midazolam, dexmedetomidine showed a more significant effect on stabilizing hemodynamic parameters during craniotomies that required skull-pin head-holder insertion. Besides, the need for hemodynamic control drugs was lower after the administration of dexmedetomidine.

Keywords

• craniotomy
• dexmedetomidine
• neurosurgery
• midazolam
• hemodynamics