The Efficacy of Regional Scalp Block in Craniotomy

NCT ID: NCT06720285

Last Updated: 2024-12-06

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

EARLY_PHASE1

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-01

Study Completion Date

2023-11-30

Brief Summary

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The objective of this clinical trial is to evaluate the role of scalp nerve block in craniotomy. The primary questions it seeks to answer are: What are the efficacy and safety profiles of scalp nerve block in craniotomy? The anesthesia protocol and monitoring were standardized for all participants. Participants were divided into two groups: the scalp nerve block group and the general anesthesia group. General anesthesia was induced using fentanyl (1-2 mcg/kg), propofol (1-2 mg/kg), and rocuronium (0.6 mg/kg). In the scalp nerve block group, a nerve block was administered using 0.5% ropivacaine.

Detailed Description

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Conditions

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Scalp Nerve Block Craniotomy Surgery

Keywords

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Regional anesthesia Scalp Nerve Block Craniotomy Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Standard Treatment with Scalp Nerve Block

General anesthesia induction was performed by administering fentanyl 1-2 mcg/kg, propofol 1-2 mg/kg, and rocuronium 0.6 mg/kg. Subsequently, scalp nerve block was performed with 0.5% ropivacaine.

During surgery, a sudden rise of heart rate and blood pressure higher than 20% from baseline was considered as pain, and a bolus of fentanyl was administered as rescue analgesia.

Group Type EXPERIMENTAL

nerve block with 0.5% ropivacaine

Intervention Type PROCEDURE

Compared to active comparator arm, the experimental arm received the same procedure except in the analgesia maintenance which was performed by nerve block of the scalp using 0.5% ropivacaine. However, during craniotomy surgery, pain may occur in patients in any arms. This was defined as a sudden rise of heart rate and blood pressure higher than 20% from baseline. In that case, a bolus of fentanyl was administered as rescue analgesia.

General anesthesia and opioids (fentanyl, propofol, rocuronium)

Intervention Type DRUG

Compared to experimental arm, the active comparator arm received the same procedure except in the analgesia maintenance which was performed through continuous fentanyl infusion. However, during craniotomy surgery, pain may occur in patients in any arms. This was defined as a sudden rise of heart rate and blood pressure higher than 20% from baseline. In that case, a bolus of fentanyl was administered as rescue analgesia.

Standard Treatment

General anesthesia induction was performed by administering fentanyl 1-2 mcg/kg, propofol 1-2 mg/kg, and rocuronium 0.6 mg/kg. Then, continuous fentanyl infusion as analgesia maintenance as the standard treatment. During surgery, a sudden rise of heart rate and blood pressure higher than 20% from baseline was considered as pain, and a bolus of fentanyl was administered as rescue analgesia.

Group Type ACTIVE_COMPARATOR

General anesthesia and opioids (fentanyl, propofol, rocuronium)

Intervention Type DRUG

Compared to experimental arm, the active comparator arm received the same procedure except in the analgesia maintenance which was performed through continuous fentanyl infusion. However, during craniotomy surgery, pain may occur in patients in any arms. This was defined as a sudden rise of heart rate and blood pressure higher than 20% from baseline. In that case, a bolus of fentanyl was administered as rescue analgesia.

Interventions

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nerve block with 0.5% ropivacaine

Compared to active comparator arm, the experimental arm received the same procedure except in the analgesia maintenance which was performed by nerve block of the scalp using 0.5% ropivacaine. However, during craniotomy surgery, pain may occur in patients in any arms. This was defined as a sudden rise of heart rate and blood pressure higher than 20% from baseline. In that case, a bolus of fentanyl was administered as rescue analgesia.

Intervention Type PROCEDURE

General anesthesia and opioids (fentanyl, propofol, rocuronium)

Compared to experimental arm, the active comparator arm received the same procedure except in the analgesia maintenance which was performed through continuous fentanyl infusion. However, during craniotomy surgery, pain may occur in patients in any arms. This was defined as a sudden rise of heart rate and blood pressure higher than 20% from baseline. In that case, a bolus of fentanyl was administered as rescue analgesia.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Aged \>18 years
* American Society of Anesthesiologists (ASA) classification I-III
* Glasgow Coma Scale (GCS) score ≥ 13
* Elective craniotomy

Exclusion Criteria

\- Patients with cardiovascular abnormalities, impaired renal and hepatic function, diabetes mellitus, systemic and/or scalp local infection, and those with a history of current dexamethasone administration
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dr. Soetomo Hospital, Surabaya

UNKNOWN

Sponsor Role collaborator

Kementerian Riset dan Teknologi / Badan Riset dan Inovasi Nasional, Indonesia

OTHER_GOV

Sponsor Role collaborator

Universitas Airlangga

OTHER

Sponsor Role lead

Responsible Party

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Dr. Christijogo Soemartono Waloejo

MD, Ph.D

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christijogo Soemartono Waloejo, MD, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Anesthesiology and Reanimation Department, Dr. Soetomo General Hospital, Universitas Airlangga, Indonesia

Locations

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Dr. Soetomo Hospital, Surabaya

Surabaya, East Java, Indonesia

Site Status

Countries

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Indonesia

References

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Chen Y, Ni J, Li X, Zhou J, Chen G. Scalp block for postoperative pain after craniotomy: A meta-analysis of randomized control trials. Front Surg. 2022 Sep 26;9:1018511. doi: 10.3389/fsurg.2022.1018511. eCollection 2022.

Reference Type BACKGROUND
PMID: 36225222 (View on PubMed)

Costello TG, Cormack JR. Anaesthesia for awake craniotomy: a modern approach. J Clin Neurosci. 2004 Jan;11(1):16-9. doi: 10.1016/j.jocn.2003.09.003. No abstract available.

Reference Type BACKGROUND
PMID: 14642359 (View on PubMed)

Benyahia NM, Verster A, Saldien V, Breebaart M, Sermeus L, Vercauteren M. Regional anaesthesia and postoperative analgesia techniques for spine surgery - a review. Rom J Anaesth Intensive Care. 2015 Apr;22(1):25-33.

Reference Type BACKGROUND
PMID: 28913452 (View on PubMed)

Vadivelu N, Kai AM, Tran D, Kodumudi G, Legler A, Ayrian E. Options for perioperative pain management in neurosurgery. J Pain Res. 2016 Feb 10;9:37-47. doi: 10.2147/JPR.S85782. eCollection 2016.

Reference Type BACKGROUND
PMID: 26929661 (View on PubMed)

Ghai B, Jafra A, Bhatia N, Chanana N, Bansal D, Mehta V. Opioid sparing strategies for perioperative pain management other than regional anaesthesia: A narrative review. J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):3-10. doi: 10.4103/joacp.JOACP_362_19. Epub 2022 Feb 4.

Reference Type BACKGROUND
PMID: 35706649 (View on PubMed)

Gottschalk A, Berkow LC, Stevens RD, Mirski M, Thompson RE, White ED, Weingart JD, Long DM, Yaster M. Prospective evaluation of pain and analgesic use following major elective intracranial surgery. J Neurosurg. 2007 Feb;106(2):210-6. doi: 10.3171/jns.2007.106.2.210.

Reference Type BACKGROUND
PMID: 17410701 (View on PubMed)

Other Identifiers

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INA-XOYLZRE

Identifier Type: REGISTRY

Identifier Source: secondary_id

IRB: 0769/KEPK/IX/2023

Identifier Type: -

Identifier Source: org_study_id