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Preemptive scalp infiltration with 0.5 % ropivacaine and 1 % lidocaine reduces postoperative pain after craniotomy

  • Clinical Article - Neurosurgical Techniques
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Abstract

Background

In order to reduce the consequences of narcotic-related side effects and provide effective analgesia after craniotomy, we conducted a randomized trial to compare the analgesic efficacy of preemptive scalp infiltrations with 1 % lidocaine and 0.5 % ropivacaine on the postoperative pain.

Methods

Sixty adult patients scheduled for craniotomy were enrolled. A solution contained 0.5 % ropivacaine and 1 % lidocaine (40 ml) was prepared. In group A, local anesthetic was injected throughout the entire thickness of the scalp before skin incision. In group B, it was injected before skin closure. Additional intravenous injection and patient-controlled analgesia with morphine was used to control postoperative pain if the verbal numerical rating scale > 4. Cumulative morphine consumption; numerical rating scale of pain at 1, 2, 4, 6, 8, 12, and 24 h; postoperative nausea, vomiting, and respiratory depression, were recorded for 24 h after the operation.

Results

Postoperative pain scores were lower in group A than in group B within the first 6 h after surgery. Mean time to demand for postoperative analgesic was statistically (p < 0.001) delayed in group A 300 (240, 360) min compared to group B 150 (105, 200) min. Ten patients in group A received morphine analgesia was half less than 21 patients in group B (p < 0.006). The median morphine consumption in 24 h after operation in group A 10.5 (8, 15) mg was less than that in group B 28 (22.5, 30.5) mg (p < 0.001).

Conclusions

Preemptive scalp infiltration with 0.5 % ropivacaine and 1 % lidocaine provides effective postoperative analgesia after craniotomy.

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Ethical standards

We state that all persons have given their informed consent prior to their inclusion in the study.

Conflict of interest

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Authors and Affiliations

  1. Departments of Neurological Surgery, Union Medical Center, Tianjin, China

    Jie Song, Pengtao Yu & Kui Liu

  2. Departments of Anesthesiology, Union Medical Center, 190#, Jieyuan Road, Hongqiao District, Tianjin, China, 300121

    Li Li & Tao Gao

Authors
  1. Jie Song
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  2. Li Li
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  3. Pengtao Yu
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  4. Tao Gao
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  5. Kui Liu
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Correspondence to Li Li.

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Song, J., Li, L., Yu, P. et al. Preemptive scalp infiltration with 0.5 % ropivacaine and 1 % lidocaine reduces postoperative pain after craniotomy. Acta Neurochir 157, 993–998 (2015). https://doi.org/10.1007/s00701-015-2394-8

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  • DOI: https://doi.org/10.1007/s00701-015-2394-8

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