Effects of Regional Scalp Block with Ropivacaine 0.5% Preincision as A Preemptive Analgesia After Craniotomy Surgery

Studies reported that more than 55% of patients complained of moderate to severe pain up to 48 hours post craniotomy. Fentanyl is the drug of choice to manage acute pain with disadvantages. Regional scalp block (RSB) technique using local anesthesia may be an alternative for post craniotomy pain management. Objective: to analyze the effects of RSB using ropivacaine 0.5% before incision compared to general anesthesia alone on the pain scale and opioid requirements 24-hour post craniotomy. This is a single-blind randomized experimental study. 14 Subjects were divided into two intervention groups. Patients were 18–64 years, GCS (Glasgow Coma Scale) 15, physical status ASA (American Society of Anesthesiologists) 1–3, undergoing craniotomy. In this study, the mean of fentanyl dose in RSB group was smaller than the group without RSB, which was statistically significant (p=0.017). Pain was also significantly reduced in RSB group at 30 minutes (p=0.009), 1 hour (p=0.003), 2 hours (p=0.003), 4 hours (p=0.001), 8 hours (p=0.050), and 12 hours (p=0.003) post-surgery. There was no difference in pain scale between the two groups at 24 hours post-surgery (p=0.393). RSB using ropivacaine 0.5% preincision is more effective in reducing pain scale up to 12 hours and also reduced the requirement of fentanyl within 24-hours post craniotomy compared to general anesthesia alone