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Effect of Scalp Block on Intraoperative Hemodynamics and Postoperative Pain in Craniotomy Patients"

Sponsor: Bangladesh Medical University • ClinicalTrials.gov ID: NCT07496632

Registry updated: 2026-09-30

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Description

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

Interventions

Surgical site infiltration with plain bupivacaine (Procedure)
Participants 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)
Participants 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.

Eligibility criteria

Inclusion Criteria: * 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. * GCS score of 9 to 15. Exclusion Criteria: * 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. * Patients with open skull defects.

Conditions

Scalp Block

Locations

Bangladesh Medical University — Dhaka, Bangladesh

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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