Effect of Scalp Block on Postoperative nausea and vomiting & Recovery Profile after Craniotomy: A Randomized, Double-Blind, Controlled Study Postoperative nausea and vomiting after Craniotomy
Journal of Cellular & Molecular Anesthesia,
Vol. 5 No. 4 (2020),
14 December 2020
,
Page 235-245
https://doi.org/10.22037/jcma.v5i4.32015
Abstract
Background:
Scalp block with bupivacaine has shown to provide perioperative analgesia with subsequent decrease in intraoperative opioids consumption. We performed a prospective randomized controlled study to evaluate the efficacy of preemptive scalp block in preventing Postoperative nausea and vomiting (PONV) after elective supratentorial craniotomy
Methods:
40 patients were randomly allocated to either control group or preemptive scalp block group. Postoperative nausea & vomiting incidence & severity during 1st 24 hours after operation were recorded.
Results:
We found that PONV% was statistically insignificant between the 2 groups; 50% in control group, 45% in Scalp block group. On the other hand, Scalp block blunted response of both mean arterial blood pressure and heart rate with noxious stimuli during pinning and skin incision together with improvement in recovery profile.
Conclusions:
Scalp block, combined with general anesthesia provided good hemodynamic stability and better recovery profile during craniotomy but on the other hand, had no effect on PONV incidence during 1st 24 h.
- Craniotomy; Neurosurgery; Postoperative nausea and vomiting; PONV; Recovery Profile; Rescue Antiemetics; Scalp Block.
How to Cite
References
Uribe AA, Stoicea N, Echeverria-Villalobos M, Todeschini AB, Esparza Gutierrez A, Folea AR, et al. Postoperative Nausea and Vomiting After Craniotomy: An Evidence-based Review of General Considerations, Risk Factors, and Management. J Neurosurg Anesthesiol. 2019.
Lu D, Wang Y, Zhao T, Liu B, Ye L, Zhao L, et al. Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial. BMC Neurol. 2020;20(1):150.
Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350(24):2441-51.
Jangra K, Kumari K, Panda NB, Samagh N, Luthra A. Postoperative nausea and vomiting in neurosurgical patients: Current concepts and management. Neurol India. 2018;66(4):1117-23.
Latz B, Mordhorst C, Kerz T, Schmidt A, Schneider A, Wisser G, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors. J Neurosurg. 2011;114(2):491-6.
Lv JQ, Wang C, Yang Y, Li Y, Xu TH, Jian LQ. Intradermal thumbtack needle buried Neiguan (P6) point for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomised controlled trial. BMJ Open. 2019;9(11):e032417.
Andrews PL, Sanger GJ. Nausea and the quest for the perfect anti-emetic. Eur J Pharmacol. 2014;722:108-21.
Jain V, Mitra JK, Rath GP, Prabhakar H, Bithal PK, Dash HH. A randomized, double-blinded comparison of ondansetron, granisetron, and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. J Neurosurg Anesthesiol. 2009;21(3):226-30.
Pinosky ML, Fishman RL, Reeves ST, Harvey SC, Patel S, Palesch Y, et al. The effect of bupivacaine skull block on the hemodynamic response to craniotomy. Anesth Analg. 1996;83(6):1256-61.
Bala I, Gupta B, Bhardwaj N, Ghai B, Khosla VK. Effect of scalp block on postoperative pain relief in craniotomy patients. Anaesth Intensive Care. 2006;34(2):224-7.
Lee EJ, Lee MY, Shyr MH, Cheng JT, Toung TJ, Mirski MA, et al. Adjuvant bupivacaine scalp block facilitates stabilization of hemodynamics in patients undergoing craniotomy with general anesthesia: a preliminary report. J Clin Anesth. 2006;18(7):490-4.
Zhang D, Shen Z, You J, Zhu X, Tang QF. Effect of ondansetron in preventing postoperative nausea and vomiting under different conditions of general anesthesia: a preliminary, randomized, controlled study. Ups J Med Sci. 2013;118(2):87-90.
Tonković D, Stambolija V, Lozić M, Martinović P, Pavlović D, Sekulić A, et al. Scalp block for hemodynamic stability during neurosurgery. Period Biol. 2015;117:247-50.
Tuchinda L, Somboonviboon W, Supbornsug K, Worathongchai S, Limutaitip s. Bupivacaine scalp nerve block: hemodynamic response during craniotomy, intraoperative and post-operative analgesia. Asian Biomed. 2018;4(2):243-51.
Gazoni FM, Pouratian N, Nemergut EC. Effect of ropivacaine skull block on perioperative outcomes in patients with supratentorial brain tumors and comparison with remifentanil: a pilot study. J Neurosurg. 2008;109(1):44-9.
Yang Y, Ou M, Zhou H, Tan L, Hu Y, Li Y, et al. Effect of Scalp Nerve Block with Ropivacaine on Postoperative Pain in Patients Undergoing Craniotomy: A Randomized, Double Blinded Study. Sci Rep. 2020;10(1):2529.
Rigamonti A, Garavaglia MM, Ma K, Crescini C, Mistry N, Thorpe K, et al. Effect of bilateral scalp nerve blocks on postoperative pain and discharge times in patients undergoing supratentorial craniotomy and general anesthesia: a randomized-controlled trial. Can J Anaesth. 2020;67(4):452-61.
Hwang JY, Bang JS, Oh CW, Joo JD, Park SJ, Do SH, et al. Effect of scalp blocks with levobupivacaine on recovery profiles after craniotomy for aneurysm clipping: a randomized, double-blind, and controlled study. World Neurosurg. 2015;83(1):108-13.
Yang X, Ma J, Li K, Chen L, Dong R, Lu Y, et al. 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. BMC Anesthesiol. 2019;19(1):91.
Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol. 2009;26(4):298-303.
Abbass O, Hussien G, Aboeldahab H, Othman S, Fareed M. Does scalp block with general anesthesia in craniotomy affect the intraoperative course and outcome in geriatric patients? Ain-Shams J Anaesthesiol. 2015;8(1):25-30.
Can BO, Bilgin H. Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial. J Int Med Res. 2017;45(2):439-50.
Bracho P, Alne R, Barcelos G, Sindou M, Naous H. Levobupivacaine scalp nerve block: haemodynamics and anaesthesia requirements in supratentorial craniotomy P 096. Eur J Anaesthesiol. 2008;25:33-4.
- Abstract Viewed: 266 times
- PDF Downloaded: 201 times