Efficacy Of Scalp Block And Ultrasound Guided TAP Block With Clonidine As Adjuvant To Ropivacaine Versus Intravenous Fentanyl On Intraoperative Hemodynamics And Perioperative Analgesia In Abdominal Bone Flap Cranioplasties
Condition: Condition: Abdominal Bone Flap Cranioplasty; Focus of Study: Perioperative Analgesia
MeSH terms: Agnosia
Study type: Interventional
Phase: Phase 4

Summary: 
      This study assesses efficacy of scalp block and Ultrasound guided transverse abdominis plane
      (TAP) block with 1µg/kg clonidine as adjuvant to 0.2% ropivacaine versus intravenous fentanyl
      (0.1µg/kg/hr) on intraoperative hemodynamics and perioperative analgesia in abdominal bone
      flap cranioplasties (ABFC).
    

Detailed description: 
      Scalp blocks with local anaesthetic agents along with general anaesthesia provides
      intraoperative and postoperative analgesia by blunting the hemodynamic responses to noxious
      stimuli. The transversus abdominis plane "TAP" block, a regional anaesthesia technique that
      provides analgesia following abdominal surgery. It involves a single large bolus injection of
      local anaesthetic into an anatomical space between the internal oblique and transversus
      abdominis muscles.

      Ropivacaine is less cardio toxic, less arrhythmogenic, less toxic to central nervous system
      (CNS) than bupivacaine, and it also has intrinsic vasoconstrictor property. Clonidine is an
      alpha-2 receptor agonist, which has a known property of reducing requirement of analgesics in
      the perioperative period.

      This study aimed to assess the efficacy of scalp block and TAP block with 1µg/kg clonidine as
      adjuvant to 0.2% ropivacaine versus intravenous fentanyl (0.1µg/kg/hr) on intraoperative
      hemodynamics and perioperative analgesia in abdominal bone flap cranioplasties.
    

Intervention name(s): Unilateral Scalp Block; Transversus abdominis plane block; Intravenous Fentanyl
Intervention type(s): Procedure; Procedure; Drug
Intervention description(s): Scalp block is provided by injecting local anaesthetic in the scalp at specific areas to block 6 nerves which are responsible for sensory innervation of the scalp - Supraorbital and supratrochlear nerves, Zygomaticotemporal nerve, Auriculotemporal nerve, Greater and lesser occipital nerves.; The transverse abdominis plane (TAP) block is a peripheral nerve block designed to anesthetize the nerves supplying the anterior abdominal wall (T6 to L1). It is usually accomplished by a single bolus injection into the transversus abdominis plane through the lumbar triangle of Petit and can be accomplished either by blind landmark based technique or alternatively under ultrasound guidance (as in this study).; Fentanyl is a commonly used opioid drug administered for analgesia in the perioperative period. It may be used as either intermittent bolus administration or continuous infusion or a combination of the two. Usual infusion doses range from 1-2 microgram/kg/hr, which may be titrated based on intraoperative haemodynamics or postoperative patient reported pain scores.
Other intervention name(s): TAP block
Intervention MeSH terms: Fentanyl
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: Scalp block; Transversus abdominis plane block; Ropivacaine; Clonidine