scholarly journals A Comparison Between Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Lei Chen ◽  
Rui Dong ◽  
Ke Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Postoperative Pain Control ◽  
Randomized Controlled ◽  
Local Anesthetic Infiltration

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.

scholarly journals A Comparison Between Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2018 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Lei Chen ◽  
Rui Dong ◽  
Ke Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Pain Intensity ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Group I ◽  
Local Anesthetic Infiltration

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.

scholarly journals A Comparison of Effects of Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Ke Li ◽  
Rui Dong ◽  
Lei Chen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Pain Intensity ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Group I ◽  
Local Anesthetic Infiltration

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

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