This study aims to compare dexmedetomidine as an adjuvant to bupivacaine in scalp block versus bupivacaine alone for postoperative pain management in patients undergoing craniotomy.
Age from 18 to 65 years.
Both sexes.
American Society of Anesthesiologists (ASA) physical status I or II.
Undergoing supratentorial elective planned craniotomies.
Patients refusal.
History of known allergy to the used local anesthetic or dexmedetomidine.
Bleeding disorders.
Evidence of local infection at the site of injection.
Parallel
Scalp block
Other interventionPatients will receive a scalp block with bupivacaine alone.
Scalp block + Dexmedetomidine
Other interventionPatients will receive a scalp block with dexmedetomidine as an adjuvant to bupivacaine.
Cumulative postoperative morphine consumption
If the Visual Analogue Scale (VAS) score is ≥3, rescue analgesia will be administered; intravenous morphine will be given at a dose of 0.05 mg/kg
Mean arterial pressure
Mean arterial pressure will be measured at baseline, before Mayfield placement, 5 minutes after Mayfield insertion, at the end of surgery, and postoperatively at 2, 4, 6,12, and 24 hours postoperatively.
Heart rate
Heart rate will be measured at baseline, before Mayfield placement, 5 minutes after Mayfield insertion, at the end of surgery, and 2, 4, 6, 12, and 24 hours postoperatively.
Degree of pain
Pain intensity will be evaluated on a 0-10 visual analog scale (VAS). The VAS consists of a 10 cm line, with two endpoints representing 0 ('no pain') and 10 ('pain as bad as it could possibly be'). The VAS score will be recorded at baseline (after admission to PACU), then after 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours postoperatively.
Time for 1st rescue analgesia
Time for 1st rescue analgesia will be recorded from the end of surgery till first dose of morphine administrated.
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