Effect of Scalp Block on Postoperative Nausea and Vomiting & Recovery Profile after Craniotomy: A Randomized, Double-Blind, Controlled Study

Background: Scalp block with bupivacaine has been shown to provide perioperative analgesia with a subsequent decrease in intraoperative opioids consumption. We performed a prospective randomized controlled study to evaluate the efficacy of preemptive scalp block in preventing Postoperative nausea and vomiting (PONV) after elective supratentorial craniotomy.Materials and Methods: ۴۰ patients were randomly allocated to either the control group or the preemptive scalp block group. Postoperative nausea & vomiting incidence & severity during ۱st ۲۴ hours after operation were recorded.Results: PONV prevalence was statistically insignificant between the ۲ study groups; ۵۰% in the control group, ۴۵% in the scalp block group. On the other hand, scalp block blunted response of both mean arterial blood pressure and heart rate with noxious stimuli during pinning and skin incision together with improvement in recovery profile.Conclusions: Scalp block, combined with general anesthesia provided good hemodynamic stability and better recovery profile during craniotomy but on the other hand, did not affect PONV incidence during ۱st ۲۴ h.

Keywords:

Craniotomy , Neurosurgery , Postoperative nausea and vomiting , PONV , Recovery Profile , Rescue Antiemetics , Scalp Block