Effect of Bilateral Scalp Nerve Block on Postoperative Pain and Discharge in Patients Undergoing Supratentorial Craniotomy

Background: Post-craniotomy pain has historically been under-addressed, largely due to the prevailing notion that such pain is typically mild to moderate in intensity. As a result, it has received limited and inconsistent attention in clinical research. This research evaluated and compared the pain-relieving effectiveness of bilateral scalp nerve block (BSNB) versus the traditional use of opioids in cases undergoing supratentorial craniotomy. Aim: Direct: Improve post-operative pain outcome in supratentorial crainotomy and decrease the need for post-operative morphine use. Indirect: Decrease hospital stay time. Methods: A prospective clinical study was conducted with 50 patients scheduled for elective supratentorial craniotomy .The participants were randomly divided into two equal groups. The control group (Group A) received only GA, while the intervention group (Group B) received GA combined with BSNB. Results: Operative time was significantly longer in Group B in contrast with Group A (P<0.001), likely due to the additional time required to perform the nerve block. Postoperative pain scores, assessed at multiple intervals, were significantly diminished in Group B across all measured time points (P<0.001). Additionally, Group A demonstrated a markedly higher requirement for morphine postoperatively (P<0.001), whereas the need for rescue analgesia was significantly reduced in Group B (P<0.001). Conclusion: BSNB provides superior postoperative analgesia in cases undergoing supratentorial craniotomy. Cases who received BSNB experienced significantly diminished pain scores, a longer duration before requiring rescue analgesia, and reduced opioid consumption. Furthermore, the BSNB group exhibited enhanced intraoperative and postoperative hemodynamic stability, indicating a diminished sympathetic response to surgical stimuli and nociceptive stress.