Effects of SCALP Block on Postoperative Analgesia in Craniotomy Surgery

NCT06588751 | Completed

• 1 other identifier: scalp
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Patients undergoing craniotomy surgery often experience severe postoperative pain. This pain can affect the patient's hemodynamics, disrupt sleep patterns, and prolong hospital stays. Sudden increases in heart rate and blood pressure due to pain may lead to elevated intracranial pressure in patients, potentially causing morbidity and mortality. Opioids are commonly used to mitigate hemodynamic fluctuations and reduce postoperative pain; however, they may delay recovery, contribute to excessive sedation, and affect postoperative neurological examinations. Additionally, opioids have adverse effects such as nausea, vomiting, and respiratory depression. Alleviating hemodynamic instability and postoperative pain are critical concerns for neuro anesthesiologists. Regional analgesia techniques are employed in neurosurgery patients because they minimize anesthesia requirements, alleviate pain, and allow for neurological assessment with a lower incidence of systemic complications.The scalp block was developed due to its potential benefits as an effective regional anesthesia technique that supports the advancement of delicate brain surgeries such as functional and microsurgeries.

Conditions

Analgesia

Outcome Measures

Primary Outcomes (1)

• Scalp

  Our primary objective is to evaluate postoperative numerical rating scale scores in patients undergoing craniotomy surgery with a SCALP block. (Numerical rating scale score 0-10 point. 0= Very Bad, 10= Very Good

  One day

Study Arms (2)

control group

ACTIVE COMPARATOR

After the surgery was completed, each patient received 3 mg of morphine IV and 8 mg of dexamethasone IV. Upon transfer to the intensive care unit, patients were administered 1 g of paracetamol IV three times a day and 20 mg of tenoxicam IV twice daily.

Other: Scalp block

scalp block

OTHER

After the surgical procedure, patients in Group S were placed in a semi-sitting position. Following skin antisepsis with 5% povidone-iodine, a sterile drape was applied. A circumferential scalp block with 2 cc of 0.25% bupivacaine was done on each of the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves that supply the forehead and scalp with sensory information. The procedure was performed bilaterally. The supratrochlear and supraorbital nerves were blocked at the brow, close to the upper middle edge orbit, and over the supraorbital notch that could be felt. The zygomaticotemporal nerve was blocked between the posterior edge of the zygomatic arch. The auriculotemporal nerve was blocked at the level of the tragus. The greater and lesser occipital nerves were blocked at the medial and lateral thirds of the superior nuchal line.

Other: Scalp block

Interventions

Scalp block OTHER

After the surgical procedure, patients in Group S were placed in a semi-sitting position. Following skin antisepsis with 5% povidone-iodine, a sterile drape was applied. A circumferential scalp block with 2 cc of 0.25% bupivacaine was done on each of the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves that supply the forehead and scalp with sensory information. The procedure was performed bilaterally. The supratrochlear and supraorbital nerves were blocked at the brow, close to the upper middle edge orbit, and over the supraorbital notch that could be felt. The zygomaticotemporal nerve was blocked between the posterior edge of the zygomatic arch. The auriculotemporal nerve was blocked at the level of the tragus. The greater and lesser occipital nerves were blocked at the medial and lateral thirds of the superior nuchal line.

control group; scalp block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years
• General anesthesia
• American Society of Anesthesiologists physical status I-III

You may not qualify if:

• Contraindications to regional anesthesia
• Coagulation disorders
• Known allergy to local anesthetics
• Infections at the block site
• Pregnant patients
• Emergency cases

Sponsors & Collaborators

• Konya City Hospital: lead

Study Sites (1)

Konya City Hospital

Konya, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Specialist, Department of Anesthesiology, Konya City Hospital, M.D

Model Details: After the surgical procedure, patients in Group S were placed in a semi-sitting position. Following skin antisepsis with 5% povidone-iodine, a sterile drape was applied. A circumferential scalp block with 2 cc of 0.25% bupivacaine was done on each of the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves that supply the forehead and scalp with sensory information. The procedure was performed bilaterally. The supratrochlear and supraorbital nerves were blocked at the brow, close to the upper middle edge orbit, and over the supraorbital notch that could be felt. The zygomaticotemporal nerve was blocked between the posterior edge of the zygomatic arch. The auriculotemporal nerve was blocked at the level of the tragus. The greater and lesser occipital nerves were blocked at the medial and lateral thirds of the superior nuchal line.

Study Record Dates

• First Submitted: September 7, 2024
• First Posted: September 19, 2024
• Study Start: October 7, 2024
• Primary Completion: November 11, 2024
• Study Completion: November 11, 2024
• Last Updated: November 12, 2024

Record last verified: 2024-11

Locations

TU (1)