The effect of preemptive scalp block in supratentorial brain tumor excision surgery: A prospective randomized controlled double blinded study

Background: The primary function of scalp blocks in managing postoperative pain following the removal of supratentorial brain tumors primarily involves blocking pain signals to the central nervous system and improving the effectiveness of postoperative pain relief medication. The primary objective of this study was to evaluate the impact of preemptive bilateral scalp block on intraoperative anesthetic and analgesic needs, recovery features, and postoperative pain in supratentorial brain tumor resection operations.Methods: In this prospective, randomised, double-blind trial, 72 patients of both sexes, ages 18 to 70, had general anaesthesia while having a craniotomy to remove supratentorial tumours. The participants were split into two identical groups - Group I (comprising 36 individuals) received a sham scalp block, while Group II (also with 36 individuals) received a real scalp block.Results: The outcomes showed that compared to group II, individuals in group I exhibited longer times to extubation, delayed spontaneous eye opening, obeying commands, reaching a modified Aldert's score of 10 minutes, first requests for pain relief, and significantly higher intraoperative fentanyl and propofol consumption (p< 0.05). Heart rate and mean arterial blood pressure recordings at 1, 3, 5, 15, 30, 45, and 60 minutes after pin insertion revealed a substantial decrease in group II compared to group I. Furthermore, a significant decrease in group II versus group I was observed on the numerical rating scale at 2, 4, and 6 hours postoperatively, with a probability of less than 0.05. The duration of ICU and hospital stays, as well as the occurrence of complications, were essentially equivalent in both groups.Conclusions: Preemptive scalp block with 0.5% bupivacaine plus 1:200000 epinephrine allows smooth recovery by the end of surgery as early extubation, rapid spontaneous eye opening and obeying commands, shorter time for Aldert's score to reach 10.