Abstract：
BACKGROUND: In patients who are candidates for craniotomy, scalp nerve blocks have been shown to be effective in relieving pain intensity as well as postoperative hemodynamic stability after surgery, but the results have been inconsistent. We aimed to assess the effect of scalp block on pain control, intraoperative drug use under Analgesia Nociception Index (ANI) monitoring, and postoperative pain in patients who were candidates for elective craniotomy.
METHODS: In this randomized, single-blinded clinical trial study, candidates for craniotomy were randomly (using the block randomization method) divided into two groups before entering the operating room. The first group received a scalp block with bupivacaine (intervention), and the second group did not receive a scalp block (control) besides the routine anesthetic procedure in these patients. ANI, hemodynamic parameters, and the amounts of received remifentanil were conducted and compared.
RESULTS: Patients under scalp block received less dosage of fentanyl than the non-scalp block group (mean = 57.14±15.59 mcg vs. 250.00±65.04 mcg, respectively). Similarly, the dose of remifentanil required in the scalp block group was less (mean = 3.04±1.95mg and 5.54±2.57mg, respectively). No difference was observed in hemodynamic parameters such as blood pressure and heart rate (before, during, and after surgery). However, the group receiving scalp block had higher ANI means than the control group.
CONCLUSIONS: Scalp nerve block has an effective role in pain control (increasing ANI), consequently reducing the need for analgesic drugs such as fentanyl and remifentanil following craniotomy without changing the hemodynamic condition.
METHODS: In this randomized, single-blinded clinical trial study, candidates for craniotomy were randomly (using the block randomization method) divided into two groups before entering the operating room. The first group received a scalp block with bupivacaine (intervention), and the second group did not receive a scalp block (control) besides the routine anesthetic procedure in these patients. ANI, hemodynamic parameters, and the amounts of received remifentanil were conducted and compared.
RESULTS: Patients under scalp block received less dosage of fentanyl than the non-scalp block group (mean = 57.14±15.59 mcg vs. 250.00±65.04 mcg, respectively). Similarly, the dose of remifentanil required in the scalp block group was less (mean = 3.04±1.95mg and 5.54±2.57mg, respectively). No difference was observed in hemodynamic parameters such as blood pressure and heart rate (before, during, and after surgery). However, the group receiving scalp block had higher ANI means than the control group.
CONCLUSIONS: Scalp nerve block has an effective role in pain control (increasing ANI), consequently reducing the need for analgesic drugs such as fentanyl and remifentanil following craniotomy without changing the hemodynamic condition.
摘要：
背景：在接受开颅手术的患者中，头皮神经阻滞已被证明是有效地缓解疼痛强度以及术后血流动力学的稳定性，但是结果不一致。我们旨在评估头皮阻滞对疼痛控制的影响，镇痛疼痛指数（ANI）监测下的术中药物使用，和择期开颅手术患者的术后疼痛。
方法：在本随机分组中，单盲临床试验研究，开颅手术的候选人在进入手术室前被随机(采用区组随机化法)分为两组.第一组接受布比卡因头皮阻滞（干预），在这些患者中，除了常规的麻醉程序外，第二组没有接受头皮阻滞（对照）。ANI,血液动力学参数,和接受的瑞芬太尼的量进行了比较.
结果：头皮阻滞组患者接受的芬太尼剂量少于非头皮阻滞组（平均值=57.14±15.59mcgvs.250.00±65.04mcg，分别)。同样，头皮阻滞组所需的瑞芬太尼剂量较少(平均值=3.04±1.95mg和5.54±2.57mg，分别)。在血压和心率等血液动力学参数（之前，during,和手术后)。然而,接受头皮阻滞组的ANI均值高于对照组.
结论：头皮神经阻滞在控制疼痛（增加ANI）方面具有有效作用，因此，在不改变血流动力学条件的情况下，减少了开颅手术后对芬太尼和瑞芬太尼等镇痛药物的需求。
方法：在本随机分组中，单盲临床试验研究，开颅手术的候选人在进入手术室前被随机(采用区组随机化法)分为两组.第一组接受布比卡因头皮阻滞（干预），在这些患者中，除了常规的麻醉程序外，第二组没有接受头皮阻滞（对照）。ANI,血液动力学参数,和接受的瑞芬太尼的量进行了比较.
结果：头皮阻滞组患者接受的芬太尼剂量少于非头皮阻滞组（平均值=57.14±15.59mcgvs.250.00±65.04mcg，分别)。同样，头皮阻滞组所需的瑞芬太尼剂量较少(平均值=3.04±1.95mg和5.54±2.57mg，分别)。在血压和心率等血液动力学参数（之前，during,和手术后)。然而,接受头皮阻滞组的ANI均值高于对照组.
结论：头皮神经阻滞在控制疼痛（增加ANI）方面具有有效作用，因此，在不改变血流动力学条件的情况下，减少了开颅手术后对芬太尼和瑞芬太尼等镇痛药物的需求。
