Scalp Infiltration With Diprospan Plus Ropivacaine for Postoperative Pain After Craniotomy in Adults
Condition: Pain, Postoperative; Post-Craniotomy Headache
MeSH terms: Pain, Postoperative; Headache
Study type: Interventional
Phase: Phase 4

Summary: 
      Pain is common for the first 2 days after major craniotomy. A majority of patients would
      suffer from moderate-to-severe postoperative pain after undergoing craniotomy. Inadequate
      analgesia induced sympathetically mediated hypertension may lead to an increased risk for
      post-operative complications, such as arterial hypertension, intracranial hemorrhage,
      prolonged hospital stay, and mortality. Adequate pain control is essential for patients'
      prognosis and their postoperative life quality. Pain after craniotomy derives from the scalp
      and pericranial muscles. Local anesthetics administered around the incision have been
      performed clinically. However, some studies revealed that the analgesic effect of local
      anesthetics was not unsatisfactory due to its short pain relief duration. Pain is common for
      the first 2 days after major elective intracranial surgery, and the relatively short
      analgesic time of scalp infiltration does not seem to meet the requirements of craniotomy.
      Steroid such as diprospan as an adjuvant to local anesthetics intra-articular injected
      locally ameliorated pain intensity in knee osteoarthritis or in total knee arthroplasty.
      However, there has not been reported about local application of diprospan on scalp
      infiltration. Thus, the investigators suppose that pre-emptive scalp infiltration with
      steroid (diprospan) plus local anesthetic (ropivacaine) could relieve postoperative pain
      after craniotomy in adults.
    


Intervention name(s): The DR group; The R group
Intervention type(s): Drug; Drug
Intervention description(s): Miscible liquid of diprospan and ropivacaine in this study will be peri-incisional scalp infiltration with 0.5 ml diprospan, 15 ml 1% ropivacaine and 14.5 ml normal saline miscible liquids for participants who will undergo elective craniotomy. The local infiltration solution containing will be infiltrated 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 investigator.; Miscible liquid of ropivacaine in this study will be peri-incisional scalp infiltration with 15 ml 1% ropivacaine and 15 ml normal saline miscible liquids for participants who will undergo elective craniotomy. The local infiltration solution containing will be infiltrated 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 investigator.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Postoperative Pain;; Post-Craniotomy Headache; Ropivacaine; Pre-emptive Scalp Infiltration; Diprospan