Pain management in patients undergoing neurosurgery is a very important issue. The effectiveness of USG-guided scalp blocks for pain management in craniotomy surgery is currently not known. The purpose of this clinical trial is to evaluate the effectiveness of ultrasound-guided scalp block when performed in patients who undergo supratentorial craniotomies.
The main research questions this trial will answer are: 1. In patients undergoing elective supratentorial craniotomy under general anaesthesia, does USG-guided scalp block affect postoperative pain compared to standard treatment? 2. In patients undergoing elective supratentorial craniotomy under general anaesthesia, does USG-guided scalp block affect postoperative opioid consumption compared to standard treatment? 3. In patients undergoing elective supratentorial craniotomy under general anaesthesia, does USG-guided scalp block affect intraoperative haemodynamic parameters (blood pressure and heart rate) compared to standard treatment? This clinical trial compares ultrasound-guided scalp block with ropivacaine 0.375% versus standard treatment. The findings of this clinical trial may potentially revolutionise the practice of regional anaesthesia and analgesia in intracranial surgeries. This will lead to better patient outcomes by improving the perioperative care of patients undergoing craniotomy surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Scalp block will be performed under USG guidance, using the technique described by Tsan et al. The block needle used will be an echogenic block needle, with a length of 50 mm, and a diameter of 22 G. Trained personnel comprising of the investigators in this study will perform the scalp block. Using ultrasound to identify landmarks, ropivacaine 0.375% will be administered in volumes of 1.5 ml to 3 ml. The nerves targeted will be the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater auricular, lesser occipital, greater occipital and third occipital nerves.
Sarawak General Hospital
Kuching, Sarawak, Malaysia
RECRUITINGPostoperative pain
Postoperative pain as measured by the visual analogue scale, with no pain being 0 and the maximal pain possible being 10.
Time frame: Pain scores will be measured at 1, 6, 24, and 48 hours after surgery.
Opioid consumption postoperatively
Overall postoperative morphine-equivalent consumption
Time frame: Measured at 24 and 48 hours after surgery
Intraoperative blood pressure stability during stimulating points of surgery
Mean arterial pressures in mmHg at skull-pinning, skin incision and craniotomy.
Time frame: Measurements will be made at time 0 (before stimulation), time-1 (1 minute after stimulation), time-3 (3 minutes after stimulation) and time-5 (5 minutes after stimulation).
Intraoperative heart rate stability during stimulating points of surgery
Heart rates in beats per minute at skull-pinning, skin incision and craniotomy.
Time frame: Measurements will be made at time 0 (before stimulation), time-1 (1 minute after stimulation), time-3 (3 minutes after stimulation) and time-5 (5 minutes after stimulation).
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