About this trial
Supratentorial brain tumor surgeries are associated with significant nociceptive stimulation and postoperative pain, which may adversely affect patient outcomes. Scalp block has emerged as an effective regional anesthetic technique to improve analgesia and reduce opioid consumption.
Objective: To compare efficacy of ketamine versus dexmedetomidine as adjuvants to bupivacaine in scalp blocks for supratentorial brain tumor surgeries, focusing on analgesia, opioid consumption, and hemodynamic stability.
Methods:
This randomized double-blinded controlled trial included 80 patients undergoing supratentorial tumor excision, allocated equally into two groups: Group K received bupivacaine with ketamine (2 mg/kg), and Group D received bupivacaine with dexmedetomidine (1 µg/kg). Intraoperative hemodynamics, fentanyl consumption, postoperative pain scores (NRS), analgesic requirements, and complications were assessed.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Age from 20 to 60 years, both sexes, American Society of Anesthesiologists (ASA) physical status II-III, Supratentorial tumor excision, Supine Position.
Disqualifiers
Patient refusal, disturbed consciousness level (Glasgow Coma Scale [GCS] < 15). Patients who required reintubation during the study period, those not extubated. immediately after surgery, or those who awoke with neurological deficits impairing. pain assessments were excluded from the final analysis, history of psychotic disorders or previous surgeries, Poor cognitive function.
Trial design
Parallel
Treatments tested in this trial
Scalp Block with Bupivacaine
DrugAfter induction, bilateral scalp blocks were performed using a 23G needle, with local anesthetic infiltrated around supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, lesser occipital, greater occipital, and great auricular nerves, 2-3 mL per nerve.
Treatment groups
Trial outcomes
Primary outcomes
Analgesic efficacy of dexmedetomidine versus ketamine as adjuvants in scalp blocks
Compare analgesic efficacy of dexmedetomidine versus ketamine as adjuvants in scalp blocks for supratentorial tumor resection by measuring total intraoperative fentanyl consumption (in µg).
Secondary outcomes
Compare the time duration after extubating to request the first analgesia.
Compare the time duration after extubating to request the first analgesia.
Total analgesic consumption.
Total analgesic consumption in intraoperative and postoperative period till 24 hours.
NRS pain score
NRS pain score at various time points in the postoperative period till 24 hours.
Nausea and vomiting
Nausea and vomiting incidence
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