Comparative Perioperative Outcomes of Scalp Block and General Anesthesia in Cranioplasty: A Retrospective Cohort Study

Abstract Cranioplasty is routinely performed to restore cranial integrity and improve neurological outcomes. While typically performed under general anesthesia, scalp block offers a potential alternative with advantages in recovery and cost. This article compares perioperative outcomes of cranioplasty performed under scalp block versus general anesthesia. This retrospective comparative study included 58 patients who underwent cranioplasty over a 10-month period at a tertiary care center. Patients were divided into two groups: scalp block (n = 38) and general anesthesia (n = 20). Primary outcomes included postoperative pain in Visual Analogue Scale (VAS) and Quality of Recovery-15 (QoR-15). Secondary outcomes included operative time, operating room duration, hospital stay, and cost. Statistical analysis was performed using Student's t-test and chi-square test, with p < 0.05 considered significant. The scalp block group demonstrated significantly better postoperative pain control (lower VAS scores, p < 0.05) and higher QoR-15 scores (130 ± 10 vs. 105 ± 10, p < 0.01). Time spent in the operating room and total theatre complex duration were significantly lower in the scalp block group (p < 0.05). Hospital stay was reduced (1–2 vs. 2–3 days, p < 0.05), with significantly lower overall cost. No significant differences were observed in operative duration, drain output, or the timing of drain removal (p > 0.05). Cranioplasty under scalp block is a safe, efficient, and cost-effective alternative to general anesthesia, offering superior postoperative recovery and reduced health care utilization.