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Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application

Shivangi Saxena Author Department of Anesthesia and Pain Management Himalayan Institute of Medical Sciences (SRHU) Dehradun, Uttarakhand, India , Parul Jindal Corresponding author parulpjindal@yahoo.co.in Department of Anesthesia and Pain Management Himalayan Institute of Medical Sciences (SRHU) Dehradun, Uttarakhand, India , Divya Gupta Author Department of Anesthesia and Pain Management Himalayan Institute of Medical Sciences (SRHU) Dehradun, Uttarakhand, India , Ranjeet Kumar Author Department of Neurosurgery Himalayan Institute of Medical Sciences (SRHU) Dehradun, Uttarakhand, India

  1. 1 Department of Anesthesia and Pain Management, Himalayan Institute of Medical Sciences (SRHU), Dehradun, Uttarakhand, India
  2. 2 Department of Neurosurgery, Himalayan Institute of Medical Sciences (SRHU), Dehradun, Uttarakhand, India
Pages 83-89 Published 2 November 2026 DOI 10.65929/JSIA.2026.1.3.005 Rights held by the authors
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Abstract

Background and Aims: Application of skull pins can causes changes in the cerebral perfusion and its sequel can have deleterious effect. To compare the effect of dexmedetomidine and fentanyl in mitigating the hemodynamic responses, Bispectral index and Cerebral perfusion pressure changes to pin placement during elective craniotomies.

Materials and Methods: This prospective randomized study was conducted on 60 patients undergoing elective craniotomy with skull pin placement randomly categorized into 2 equal group. Group A received IV dexmedetomidine 1mcg/kg over 10 minutes and Group B received IV fentanyl 1 mcg/kg over 10 minutes prior to pin insertion. Hemodynamic parameter, central venous pressure (CVP), cerebral perfusion pressure, condition of brain and the adverse side effects of the drugs were compared in both the groups at different time intervals. One-way ANOVA test for parameters on categorical scale, independent t-test for parameters on continuous scale within the group on metric parameters.

Results: The demographic data was comparable between both the groups. No significant change in heart rate, cerebral perfusion pressure, BIS among both the groups at all the time intervals. Systolic, Diastolic, mean blood pressure and central venous pressure was significantly increased in the fentanyl as compared to the dexmedetomidine group after the pin insertion (p<0.05). Surgeons reported satisfactory brain condition in the dexmedetomidine group.

Conclusions: IV dexmedetomidine a dose of 1mcg/kg infusion over 10 minutes is a better attenuating agent than IV fentanyl 1mg/kg over 10 minutes for blunting the deleterious response to skull pin placement.

Dates & metrics

Received
20 Aug 2026
Accepted
6 Oct 2026
Published
2 Nov 2026
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4 downloads

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Keywords: Cerebral perfusion pressure Dexmedetomidine Fentanyl Hemodynamics

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How to cite this article

Saxena S, Jindal P, Gupta D, Kumar R. Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application. J. Sci. Innov. Anesthesiol. 2026;1(3):83-89. doi:10.65929/JSIA.2026.1.3.005

RIS BibTeX EndNote

Saxena, S., Jindal, P., Gupta, D., & Kumar, R. (2026). Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application. Journal of Scientific Innovations in Anesthesiology, 1(3), 83-89. https://doi.org/10.65929/JSIA.2026.1.3.005

RIS BibTeX EndNote

Shivangi Saxena, Parul Jindal, Divya Gupta, and Ranjeet Kumar. "Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application." Journal of Scientific Innovations in Anesthesiology, vol. 1, no. 3, 2026, pp. 83-89. https://doi.org/10.65929/JSIA.2026.1.3.005

RIS BibTeX EndNote

Shivangi Saxena, Parul Jindal, Divya Gupta, and Ranjeet Kumar. "Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application." Journal of Scientific Innovations in Anesthesiology 1, no. 3 (2026): 83-89. https://doi.org/10.65929/JSIA.2026.1.3.005

RIS BibTeX EndNote

Saxena, S., Jindal, P., Gupta, D., and Kumar, R. (2026) 'Effects of dexmedetomidine vs. fentanyl on neuro-hemodynamic variables and cerebral perfusion pressure during skull pin head holder application', Journal of Scientific Innovations in Anesthesiology, 1(3), pp. 83-89. https://doi.org/10.65929/JSIA.2026.1.3.005

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© 2026 the authors. Published by REVO Publication. This article is distributed under CC BY 4.0, which permits use and redistribution provided the original work is properly cited.