This study shows that in craniotomy patients using a skull pin head holder, an ultrasound-guided scalp block reduces perioperative opioid consumption, improves hemodynamic stability, and decreases the inflammatory response.
Aged 18 years and older
Scheduled for elective intracranial surgery with skull pin head holder fixation
Classified as American Society of Anesthesiologists (ASA) physical status I-III
Provided written informed consent in the preoperative period
Allergy to local anesthetics
Coagulopathy or anticoagulant use
Local infection at injection site
Pregnancy or breastfeeding
Patients aged 18 years and older who are scheduled for elective intracranial surgery under general anesthesia with planned skull pin head holder (Mayfield-type) fixation, classified as American Society of Anesthesiologists (ASA) physical status I-III, and who have provided informed consent will be included.
Cohort
Prospective
Not listed
Total opioid consumption within 24 hours postoperatively (morphine milligram equivalents, mg)
All opioid analgesics administered within 24 hours postoperatively will be converted to morphine milligram equivalents (mg) for each participant. The outcome will be reported as a single total value per participant.
Mean resting pain score at 24 hours postoperatively measured using the Numeric Rating Scale (0-10)
Pain intensity at rest will be assessed using the Numeric Rating Scale (0 = no pain, 10 = worst imaginable pain). The outcome will be reported as the mean score at 24 hours. Higher scores indicate greater pain severity.
Mean arterial pressure during pin head holder placement (mmHg)
Mean arterial pressure (MAP) will be recorded in mmHg during pin head holder placement. The outcome will be reported as the MAP value at this time point
Mean systemic immune-inflammation index at 24 hours postoperatively
The systemic immune-inflammation index (SII) will be calculated for each participant using laboratory values obtained at 24 hours postoperatively as platelet count × neutrophil count / lymphocyte count. The outcome will be reported as the mean SII value.
Mean systemic inflammation response index at 24 hours postoperatively
The systemic inflammation response index (SIRI) will be calculated for each participant using laboratory values obtained at 24 hours postoperatively as monocyte count × neutrophil count / lymphocyte count. The outcome will be reported as the mean SIRI value.
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