The goal of this clinical trial is to learn if an ultrasound-guided scalp block can improve intraoperative hemodynamic stability and provide better postoperative pain relief in adult patients undergoing elective supratentorial craniotomy. The main questions it aims to answer are:
Does ultrasound-guided scalp block reduce changes in heart rate and blood pressure during surgery compared with surgical site infiltration?
Does ultrasound-guided scalp block decrease postoperative pain and opioid requirements in the first 24 hours after craniotomy?
Researchers will compare patients receiving an ultrasound-guided scalp block to those receiving standard surgical site infiltration to see if the scalp block provides better perioperative hemodynamic control and postoperative analgesia.
Participants will:
Receive general anesthesia with either ultrasound-guided scalp block or surgical site infiltration
Have heart rate, blood pressure, and other hemodynamic parameters monitored throughout surgery
Receive standard postoperative pain management, with pain scores recorded at 0, 2, 6, 12, and 24 hours
Receive opioids as needed based on pain scores, with total opioid consumption and time to first analgesic dose recorded
Be monitored for adverse events, including nausea, vomiting, sedation, and block-related complications
Age 18-64 years.
ASA (American Society of Anesthesiologists) physical status I or II.
Patients scheduled for elective supratentorial craniotomy.
BMI of 18 to 30 kg/m².
Patient with instable blood pressure and heart rate.
Known allergy or hypersensitivity to local anesthetics.
Coagulation disorders or current anticoagulant therapy.
Infection at the injection site or systemic infection.
Parallel
Surgical site infiltration with plain bupivacaine
Procedure/SurgeryParticipants receiving this intervention will undergo local anesthetic infiltration at the planned surgical sites in addition to standard general anesthesia for elective supratentorial craniotomy. Drug: Bupivacaine 0.5% plain solution Dosage: 10-15 ml along the incision line plus 5 ml at each pin insertion site Dosage Form: Injectable solution Route: Subcutaneous and deep infiltration into the scalp Timing: Single administration immediately after induction of general anesthesia, prior to surgical incision
Scalp block with plain bupivacaine
Procedure/SurgeryParticipants receiving this intervention will undergo ultrasound-guided regional nerve blockade of the scalp in addition to standard general anesthesia for elective supratentorial craniotomy. The procedure targets the supratrochlear, supraorbital, auriculotemporal, postauricular branches of the greater auricular nerve, and the greater, lesser, and third occipital nerves.
Postoperative pain intensity by Numeric Rating Scale (NRS)
Scores range from 0 to 10, where 0 represents 'no pain' and 10 represents 'worst possible pain'. High scores indicate more pain.
Changes in heart rate (beats per minute)
Change in Systoloic Blood Pressure (SBP) (in mmHg)
Change in diastolic blood pressure (DBP) (in mmHg)
Total consumption of morphine sulfate(mg) in 24 hours
Click on the lead sponsor to view all of their trials.
