Postoperative Regional Scalp Block versus Intravenous Fentanyl for Postsupratentorial Craniotomy Analgesia in Adult Patients under General Anesthesia

Abstract

Majority of patients undergoing craniotomy experienced moderate to severe pain in surgical site after the procedure, and there is a reluctance to manage this pain with systemic opioids that is understandable as it may impair neurological assessment, that is crucial in the postoperative period. In addition to that, evidence concerning alternative analgesia techniques to manage post craniotomy pain is deficient. This research aims at evaluating the effect of postoperative regional scalp block (RSB) versus intravenous fentanyl for postsupratentorial craniotomy analgesia in adult patients under general anaesthesia. Patients were automatically divided into two groups with 15 patients in each, Group B: postoperative RSB was done after the end of skin closure and before emergence from general anaesthesia, Group C: control group: in which standard intraoperative analgesia was given in the form of intravenous fentanyl with no block. This study included patients with Supratentorial brain tumours were admitted to Zagazig University Hospitals. We gathered the cases in the time between March 2018 and March 2020. Results: the results displayed highly significant differences between RSB group and control group. Postoperative RSB showed advantages over standard analgesia in the point of more significant reduction of hemodynamic response to pain in the form of heart rate and blood pressure postoperatively, decrease opioid consumption, lower Visual Analogue Score (VAS), Postoperative RSB can be performed easily in a short time with very high success rate allowing better postoperative control of haemodynamics, less postoperative pain. We recommend using postoperative RSB in supratentorial craniotomy as a gold standard in our hospital to get the advantages as mentioned above.