This study aims to compare dexmedetomidine as an adjuvant to bupivacaine in scalp block versus bupivacaine alone for postoperative pain management in patients undergoing craniotomy.
Scalp block is proposed as a multimodal approach to preventing postoperative pain and hemodynamic responses to previous noxious stimulation during the operation. The use of adjuvants, such as dexmedetomidine, a highly selective alpha-2 adrenergic receptor agonist, has recently been studied for its analgesic effects. Dexmedetomidine acts additionally to local anesthetics, prolonging their duration of action.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Patients will receive a scalp block with bupivacaine alone.
Patients will receive a scalp block with dexmedetomidine as an adjuvant to bupivacaine.
Ain Shams University
Cairo, Egypt
RECRUITINGCumulative postoperative morphine consumption
If the Visual Analogue Scale (VAS) score is ≥3, rescue analgesia will be administered; intravenous morphine will be given at a dose of 0.05 mg/kg
Time frame: 24 hours postoperatively
Mean arterial pressure
Mean arterial pressure will be measured at baseline, before Mayfield placement, 5 minutes after Mayfield insertion, at the end of surgery, and postoperatively at 2, 4, 6,12, and 24 hours postoperatively.
Time frame: 24 hours postoperatively
Heart rate
Heart rate will be measured at baseline, before Mayfield placement, 5 minutes after Mayfield insertion, at the end of surgery, and 2, 4, 6, 12, and 24 hours postoperatively.
Time frame: 24 hours postoperatively
Degree of pain
Pain intensity will be evaluated on a 0-10 visual analog scale (VAS). The VAS consists of a 10 cm line, with two endpoints representing 0 ('no pain') and 10 ('pain as bad as it could possibly be'). The VAS score will be recorded at baseline (after admission to PACU), then after 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours postoperatively.
Time frame: 24 hours postoperatively
Time for 1st rescue analgesia
Time for 1st rescue analgesia will be recorded from the end of surgery till first dose of morphine administrated.
Time frame: 24 hours postoperatively
Incidence of complications
Incidence of complications such as postoperative nausea and vomiting, respiratory depression, or any other complication will be recorded.
Time frame: 24 hours postoperatively
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