Abstract
BACKGROUND:
The purpose of this study was to compare the effects of the scalp nerve block (SNB) and local anesthetic infiltration (LA) with ropivacaine 0.75% on postoperative inflammatory response, intraoperative hemodynamic response, and postoperative pain control in patients undergoing craniotomy.
METHODS:
Fifty seven patients admitted for elective craniotomy for surgical clipping of an cerebral aneurysm. They were randomly divided into three groups: Group S (SNB with 15mL of ropivacaine 0.75%), group I (LA with 15mL of ropivacaine 0.75%) and group C (only received routine intravenous analgesia). The pro-inflammatory cytokines levels in plasma during postoperative 72 hrs, the hemodynamic response to the skin incision, as well as postoperative pain intensity were measured.
RESULTS:
The SNB with 0.75% ropivacaine not only decreased IL-6 level in plasma at 6 hrs after craniotomy, but also decreased plasma CRP level and increased plasma IL-10 level at 12 and 24 hrs after surgery, as compared to LA and routine analgesia. There were significant increases in mean arterial pressure at 2, and 5 mins after the incision and during dura opening in group I and C compared with group S. Group S had a lower postoperative pain intensity, longer duration of time before the first dose of oxycodone, less consumption of oxycodone and lower incidence of PONV during 48 hrs postoperatively than group I and C.
CONCLUSION:
Preoperative SNB attenuated inflammatory response to craniotomy for cerebral aneurysms, as well as blunted hemodynamic response to the scalp incision, and controlled postoperative pain better than LA or routine analgesia.
A comparison of effects of scalp nerve block and local anesthetic infiltration on inflammatory response, hemodynamic response, and postoperative pain in patients undergoing craniotomy for cerebral aneurysms: a randomized controlled trial
