Effect of Scalp Blocks with Levobupivacaine on Recovery Profiles After Craniotomy for Aneurysm Clipping: A Randomized, Double-Blind, and Controlled Study

Hwang, Jin Young; Bang, Jae Seung; Oh, Chang Wan; Joo, Jin Deok; Park, Seong Joo; Hwan, Sang; Yoo, Young; Ryu, Jung Hee

doi:10.1016/j.wneu.2013.05.009

Cited by 42 publications

(66 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previous meta‐analysis published in 2013 identified a positive impact of regional scalp block for postcraniotomy analgesia, but the RCTs included were small and of limited methodological quality . Up to now, only the 3 RCTs included in our study were performed, which seem not to provide strong evidence on scalp block analgesic efficacy . During the first 6 postoperative hours, the analgesic efficacy of scalp infiltration applied prior to surgery was superior to that performed upon skin closure, while the results from scalp block applied before awakening vs. placebo presented conflicting results, as the positive results in terms of pain and PONV control can be questioned by the equivalent overall consumption of fentanyl between groups.…”

Section: Discussionmentioning

confidence: 85%

“…Application of scalp block with bupivacaine 0.75% before awakening vs. placebo significantly improved pain scores, attenuated rescue analgesic needs, prolonged time to first analgesic rescue, and reduced the incidence of PONV during the 72‐hour period of assessment . However, the overall consumption of fentanyl provided as a basic analgesic agent with a PCA device was similar between groups.…”

Section: Resultsmentioning

confidence: 94%

“…Three RCTs of scalp infiltration or scalp nerve blocks vs. active control or placebo were identified and included a total of 138 patients. The analgesic efficacy of scalp infiltration using a mixture of ropivacaine 0.5% and lidocaine 1% applied either before skin incision or closure was evaluated by 1 RCT .…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature

2017

View full text Add to dashboard Cite

No definite recommendations can be made based on this systematic review of pharamacological interventions following craniotomy due to significant divergence in the methodology of available studies. Limited evidence on scalp infiltration/block suggests an adequate analgesic effect in the early postoperative period. Analgesic efficacy of dexmedetomidine and multipoint electro-acupuncture needs further evaluation.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 94%

See 1 more Smart Citation

Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature

2017

View full text Add to dashboard Cite

show abstract

“…Although scalp block is usually associated with decreased postoperative opioid consumption [39] and decreased opioid-related adverse events (post-operative nausea and vomiting -PONV-among others), some studies have shown no clinical significant advantage associated with its use. Gazoni et al studied 30 patients schedule to undergo craniotomy under standard general anesthesia.…”

Section: Local Anesthesiamentioning

confidence: 99%

Anesthetic Considerations for Deep Brain Stimulation

Fiorda-Diaz¹,

Stoicea²,

Deogaonkar³

et al. 2016

From Bench to Bedside - Trauma, Tumors, Spine, Functional Neurosurgery

View full text Add to dashboard Cite

Deep brain stimulation (DBS) was used to treat refractory Parkinson's disease (PD) for the first time in 1987 by Professor Benabid's group by placing stimulating electrodes into targeted brain structures. DBS is a widely accepted neurosurgical treatment for Parkinson's disease (PD), benign tremor, dystonia, epilepsy, and other neuropsychiatric disorders with no significant changes in anatomical brain structures. Prior to the introduction of DBS, traditional treatment for PD involved surgical removal of parts of the brain known as thalamotomy, pallidotomy, and cingulotomy. Intraoperative identification of the affected areas of brain is possible through a couple of mechanisms involving electrical stimulation and monitoring of the brain function, known as "functional neurosurgery". Implantation of electrodes in the targeted area and the insertion of a programmable pulse generator under the clavicle or in the abdomen are the main steps in DBS surgery. Anesthetic management for DBS remains controversial and might vary between institutions and physicians. Although no guidelines have been developed, there are some common anesthetic considerations for DBS surgery, including difficult airway management, facilitation of neuromonitoring, and anesthetic drugs interference with microelectrode recordings (MERs). Local anesthesia, general anesthesia, and monitored anesthesia care (MAC) have been used worldwide in patients undergoing DBS.

show abstract

“…Long-acting local anaesthetics are helpful if available, such as bupivacaine (0.5%), levobupivacaine (0.5%), and ropivacaine (0.75%), which all should be supplemented with epinephrine to reduce systemic absorption and to elongate duration [23]. Furthermore, adequate scalp blocks are known to improve recovery profiles and postoperative pain [24]. We prefer the combination of rapid onset and long-acting local anaesthesia by combining bupivacaine (0.5%) and lidocaine (1%).…”

Section: Anaesthetic Management and Implicationsmentioning

confidence: 99%

Anaesthesia for deep brain stimulation

Grant¹,

Gruenbaum

Gerrard³

2015

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of review Deep brain stimulation (DBS) is a well tolerated and efficacious surgical treatment for movement disorders, chronic pain, psychiatric disorder, and a growing number of neurological disorders. Given that the brain targets are deep and small, accurate electrode placement is commonly accomplished by utilizing frame-based systems. DBS electrode placement is confirmed by microlectrode recordings and macrostimulation to optimize and verify target placement. With a reliance on electrophysiology, proper anaesthetic management is paramount to balance patient comfort without interfering with neurophysiology. Recent findings To achieve optimal pain control, generous amounts of local anaesthesia are instilled into the planned incision. During the opening and closing states, conscious sedation is the prevailing method of anaesthesia. The preferred agents are dexmedetomidine, propofol, and remifentanil, as they affect neurocognitive testing the least, and shorter acting. All the agents are turned off 15–30 min prior to microelectrode recording. Dexmedetomidine has gained popularity in DBS procedures, but has some considerations at higher doses. The addition of ketamine is helpful for pediatric cases. Summary DBS is a robust surgical treatment for a variety of neurological disorders. Appropriate anaesthetic agents that achieve patient comfort without interfering with electrophysiology are paramount.

show abstract

Effect of Scalp Blocks with Levobupivacaine on Recovery Profiles After Craniotomy for Aneurysm Clipping: A Randomized, Double-Blind, and Controlled Study

Cited by 42 publications

References 28 publications

Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature

Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature

Anesthetic Considerations for Deep Brain Stimulation

Anaesthesia for deep brain stimulation

Contact Info

Product

Resources

About