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Year 2020 Vol. 28 No 3

ANESTESIOLOGY-REANIMATOLOGY

D.P. MARKEVICH 1, A.V. MAROCHKOV 2

ANESTHESIA AND CORTISOL LEVEL IN PATIENTS WITH TRAUMATIC BRAIN INJURY DURING CRANIOTOMY

Mogilev City Emergency Hospital 1,
Mogilev Regional Hospital 2, Mogilev,
The Republic of Belarus

Objective. To analyze the serum cortisol level during the operation and in the early postoperative period in patients with traumatic brain injury to assess the effectiveness of anesthetic management methods for craniotomy.
Methods. The study included patients (n=111) with the traumatic brain injury. The patients of the 1st group (n=57) underwent to a combination of general anesthesia and cranial soft tissue nerve blockade with low-volumes of local anesthetics during craniotomy.
The patients of the 2nd group (n=58) underwent to general anesthesia. The serum cortisol was examined during the operation and within 10-12 hours after the intervention in 22 (38.6%) patients of the 1st group and 20 (37%) of patients in the 2nd group.
Results. During craniotomy in patients with cranial soft tissue nerve blockade the level of serum cortisol at the main stage of the operation and at the end of the intervention was lower than in patients of the 2nd group. In the 1st group cortisol level at the main stage of the operation was 136.4 (75; 325.4) ng/ml, and in the 2nd group – 258.8 (161.7; 543.5) ng/ml, p=0.024. At the initial stage of the operation in the 1st group cortisol level was 119.6 (47.6; 327.2) ng/ml, and in the 2nd group it was 323.1 (156.9; 673.1) ng/ml, p=0.027. Difference of cortisol levels in patients of both groups 10-12 hours postoperatively have not been detected.
Conclusions. The concentration of blood cortisol was lower in patients with traumatic brain injury who received a combination of general anesthesia and cranial soft tissue nerve blockades than in patients who underwent only general anesthesia. Cranial soft tissue nerve blockades with small volumes of local anesthetics in patients with traumatic brain injury during surgery demonstrated high pain relief.

Keywords: traumatic brain injury, craniotomy, cotrisol, general anesthesia, nerve blockades
p. 290-298 of the original issue
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Address for correspondence:
212030, Republic of Belarus,
Mogilev, Botkin str., 2,
Mogilev City Emergency Hospital,
Anesthesiology and Intensive Care Unit,
tel./fax: +375(222) 22-16-26,
e-mail: snyter1977@gmail.com,
Markevich Denis P.
Information about the authors:
Markevich Denis P., Head of Anesthesiology and Intensive Care Unit, Mogilev Emergency City Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0002-1117-3877
Marochkov Alexey V., MD, Professor, Anesthesiologist-Resuscitator, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0001-5092-8315
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