The Effects of Scalp Block on Haemodynamic Response and Postoperative Pain in Posterior Fossa Surgery

NCT ID: NCT02852382

Last Updated: 2017-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2016-12-31

Brief Summary

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This study evaluate the effects of scalp block versus local infiltration on haemodynamic response to head pin replacement and skin incision and postoperative analgesia in posterior fossa surgery

Detailed Description

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In this study 15 patients will receive scalp block with bupivacaine, 15 patients will receive local infiltration with bupivacaine and 15 patients will receive placebo before surgery. The haemodynamic response to head pin replacement and skin incision will be recorded. Postoperatively all patients will have a patient controlled analgesia (PCA) device containing morphine (1 mg/ml) for analgesia. Visual analogue scale (VAS) for pain evaluation, sedation scores, and also postoperative morphine consumption will be evaluated and recorded.

Conditions

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Posterior Fossa Tumors

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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scalp block

In this arm, after general anesthesia, before surgery and head pin placement, scalp block will be applied. Scalp block will be performed with bupivacaine (Marcaine 5 mg/mL, 0,5% bupivacaine); nervus supraorbitalis, nervus supratrochlearis, n. auriculotemporalis, nervus zygomaticotemporalis, nervus occipitalis majoris and minoris will be bilaterally blocked with 2-3 ml bupivacaine.

Group Type ACTIVE_COMPARATOR

Bupivacaine

Intervention Type DRUG

In the scalp block and local infiltration arms; bupivacaine %0,5 will be used.

morphine patient controlled analgesia

Intervention Type DRUG

End of the surgery all of the patients in 3 groups will receive morphine patient controlled analgesia (PCA) including 1mg/ml morphine. The PCA was set to administer a bolus dose of 1 mg on demand with a lockout period of 10 minutes and maximum 25 mg for 4 hours.

local infiltration

In this arm, after general anesthesia, before surgery, 20 ml 0,5% bupivacaine (Marcaine 5 mg/ml, 0,5% bupivacaine) will be infiltrated to head pin points and skin incision area.

Group Type ACTIVE_COMPARATOR

Bupivacaine

Intervention Type DRUG

In the scalp block and local infiltration arms; bupivacaine %0,5 will be used.

morphine patient controlled analgesia

Intervention Type DRUG

End of the surgery all of the patients in 3 groups will receive morphine patient controlled analgesia (PCA) including 1mg/ml morphine. The PCA was set to administer a bolus dose of 1 mg on demand with a lockout period of 10 minutes and maximum 25 mg for 4 hours.

control

In this arm, neither scalp block, nor local infiltration will be performed.

Group Type PLACEBO_COMPARATOR

morphine patient controlled analgesia

Intervention Type DRUG

End of the surgery all of the patients in 3 groups will receive morphine patient controlled analgesia (PCA) including 1mg/ml morphine. The PCA was set to administer a bolus dose of 1 mg on demand with a lockout period of 10 minutes and maximum 25 mg for 4 hours.

Interventions

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Bupivacaine

In the scalp block and local infiltration arms; bupivacaine %0,5 will be used.

Intervention Type DRUG

morphine patient controlled analgesia

End of the surgery all of the patients in 3 groups will receive morphine patient controlled analgesia (PCA) including 1mg/ml morphine. The PCA was set to administer a bolus dose of 1 mg on demand with a lockout period of 10 minutes and maximum 25 mg for 4 hours.

Intervention Type DRUG

Other Intervention Names

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Marcaine MORPHİNE PCA

Eligibility Criteria

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Inclusion Criteria

* Posterior fossa surgery
* Preoperative GlasGow Coma Score: 15/15

Exclusion Criteria

* Allergy to bupivacaine
* Uncontrolled hypertension
* Coagulopathy
* Cerebrovascular disease
* Earlier craniotomy
Minimum Eligible Age

16 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University

OTHER

Sponsor Role lead

Responsible Party

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Eren Fatma Akcil

Staff anesthesiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yusuf Tunali, Professor

Role: STUDY_DIRECTOR

Istanbul University Cerrahpasa Medical Faculty Department Anesthesiology and Reanimation

References

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Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol. 2009 Apr;26(4):298-303. doi: 10.1097/EJA.0b013e32831aedb2.

Reference Type RESULT
PMID: 19262392 (View on PubMed)

Hansen MS, Brennum J, Moltke FB, Dahl JB. Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review. Eur J Anaesthesiol. 2011 Dec;28(12):821-9. doi: 10.1097/EJA.0b013e32834a0255.

Reference Type RESULT
PMID: 21971206 (View on PubMed)

Verchere E, Grenier B, Mesli A, Siao D, Sesay M, Maurette P. Postoperative pain management after supratentorial craniotomy. J Neurosurg Anesthesiol. 2002 Apr;14(2):96-101. doi: 10.1097/00008506-200204000-00002.

Reference Type RESULT
PMID: 11907388 (View on PubMed)

Jellish WS, Leonetti JP, Sawicki K, Anderson D, Origitano TC. Morphine/ondansetron PCA for postoperative pain, nausea, and vomiting after skull base surgery. Otolaryngol Head Neck Surg. 2006 Aug;135(2):175-81. doi: 10.1016/j.otohns.2006.02.027.

Reference Type RESULT
PMID: 16890064 (View on PubMed)

Irefin SA, Schubert A, Bloomfield EL, DeBoer GE, Mascha EJ, Ebrahim ZY. The effect of craniotomy location on postoperative pain and nausea. J Anesth. 2003;17(4):227-31. doi: 10.1007/s00540-003-0182-8.

Reference Type RESULT
PMID: 14625709 (View on PubMed)

Schessel DA, Nedzelski JM, Rowed D, Feghali JG. Pain after surgery for acoustic neuroma. Otolaryngol Head Neck Surg. 1992 Sep;107(3):424-9. doi: 10.1177/019459989210700314.

Reference Type RESULT
PMID: 1408229 (View on PubMed)

Other Identifiers

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Cerrahpasa Neuro

Identifier Type: -

Identifier Source: org_study_id

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