Comparison of sterile silicone studs and scalp infiltration with lignocaine for the attenuation of the hemodynamic and stress response to skull pin insertion during craniotomy in pediatric neurosurgical patients: a randomized controlled trial : Sterile silicone studs versus lignocaine infiltration for skull pin insertion

Skull pin application during pediatric neurosurgery elicits a pronounced nociceptive and sympathetic response, adversely affecting cerebral hemodynamics. We compared the efficacy of sterile silicone studs (SSS) with pin site lignocaine infiltration in attenuating the response to skull pin insertion in pediatric neurosurgical patients.

Sixty-four pediatric patients (≤ 12 years, ASA I-II) were randomized to receive either SSS (Group SS, n = 32) or 2 ml of 2% plain lignocaine infiltration (Group LO, n = 32) at each skull pin insertion site. We assessed the requirement of rescue analgesia (fentanyl). The hemodynamics (Heart rate, mean arterial pressure) were also recorded at baseline, at pin insertion and at 1, 3, 5, and 10 min post pin insertion. Perioperative complications related to skull pin insertion and surgeon satisfaction were also assessed.