Pre-emptive Scalp Infiltration With Dexamethasone Plus Ropivacaine for Post-Craniotomy Pain in Children
Condition: Pain, Postoperative; Children
MeSH terms: Pain, Postoperative
Study type: Interventional
Phase: Phase 4

Summary: 
      At present, pediatric postoperative analgesia has not been fully understood and controlled,
      particularly craniotomy surgery. On the one hand, professional evaluation of postoperative
      pain for young children is difficult; on the other hand, the particularity of craniotomy adds
      (such as consciousness obstacle, sleepiness, et al) disturbance to the pain assessment in
      children. Although opioids administration is regarded as the first-line analgesic for
      post-craniotomy pain management, it may be associated with delayed awakening, respiratory
      depression, hypercarbia and it may interfere with the neurologic examination. For the
      avoidance of side-effects of systemic opioids, local anesthetics administered around the
      incision have been performed clinically. However, some studies revealed that the analgesic
      effect of local anesthetics was unsatisfactory due to its short pain relief duration, steroid
      as adjuvant can enhance postoperative analgesia and prolong postoperative analgesia time. As
      is reported that postoperative pain of craniotomy is mainly caused by skin incision and
      reflection of muscles, preventing the liberation of inflammatory mediators around the
      incision seems to be more effective than simply blocking nerve conduction. Researchers have
      clarified that the addition of dexamethasone to local infiltration of analgesia could provide
      significant analgesic effects and significantly prolong the duration of analgesic effects
      without obvious complications for various types of surgeries. To date, no studies have
      evaluated the addition of dexamethasone to local infiltration for patients receiving
      craniotomy. Thus, investigators suppose that pre-emptive scalp infiltration with steroid
      (Dexamethasone) plus local anesthetic (ropivacaine) could relieve postoperative pain after
      craniotomy in children.
    


Intervention name(s): The dexamethasone plus ropivacaine; The ropivacaine
Intervention type(s): Drug; Drug
Intervention description(s): The local infiltration solution containing 0.25mg Dexamethasone and 2mg ropivacaine per milliliter. The total volume is 20 ml. The assigned solution will be injected subcutaneously by surgeons along the incision and throughout the entire thickness of the scalp before skin incision. The volume of local infiltration solution will be decided by surgeons according to the cut length, and the capacity of the solution will be recorded by investigators.; The local infiltration solution containing 2mg ropivacaine per milliliter. The total volume is 20 ml. The assigned solution will be injected subcutaneously by surgeons along the incision and throughout the entire thickness of the scalp before skin incision. The volume of local infiltration solution will be decided by surgeons according to the cut length, and the capacity of the solution will be recorded by investigators.
Intervention MeSH terms: Dexamethasone; Ropivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention