2016 Volume 36 Issue 3 Pages 291-296
A 76-year-old man was scheduled to undergo superficial temporal artery to middle cerebral artery bypass. A thoracic aortic aneurysm was detected during preoperative examination. Because exacerbation of his cerebral infarction was expected if thoracic surgery was performed first, we performed head surgery first.
Scalp blocks were performed to suppress blood pressure fluctuations. Before induction of general anesthesia, a left greater occipital nerve block, left lesser occipital nerve block, and left greater auricular nerve block were performed under ultrasound guidance. General anesthesia was induced and a bilateral supraorbital nerve and supratrochlear nerve block, left zygomaticotemporal nerve block, and left auriculotemporal nerve block were performed according to the landmark method.
The scalp block combined with general anesthesia during craniotomy had two effects : it inhibited hypertension due to surgical stress and avoided hypotension due to a high volume of anesthetic.
