Effect of Scalp Nerve Block on the Recovery Quality of Parkinson's Patients After Deep Brain Stimulation

Study Overview
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Brief Summary
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Patients diagnosed with Parkinson's disease (PD) undergoing deep Brain Stimulation (DBS) have a higher risk of perioperative complications and postoperative pain will affect quality of recovery (QoR) resulting in longer hospitalization time and higher hospital costs. Scalp nerve block (SNB) combined with intercostal nerve block (ICNB)can alleviate postoperative pain while effect of them on postoperative recovery quality of patients diagnosed with PD was unclear. Therefore, the investigators conducted a randomized controlled trails to provide a novel method for enhanced recovery and early prevention and treatment of acute pain after DBS surgery.

Official Title
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Effect of Scalp Nerve Block Combined With Intercostal Nerve Block on Quality of Recovery After Deep Brain Stimulation in Patients With Parkinson's Disease

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: scalp nerve block combined with intercostal nerve block using 0.5% ropivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with PD who receive elective deep brain stimulation (DBS) surgery Aged ≥ 18 American Society of Anesthesiologists (ASA) physical status of I-III Able to communicate normally Exclusion Criteria: Allergy to local anesthetics Pre-existing infection at block site Severe coagulopathy Pre-existing neuropathic pain condition Previous history of DBS surgery unwilling to provide informed consent or poor compliance

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SNB group<br>patients in the SNB group will receive general anesthesia combined with scalp nerve block and intercostal nerve block with 0.5% ropivacaine. | Other: scalp nerve block combined with intercostal nerve block using 0.5% ropivacaine<br>* Participants randomized to the SNB group will receive general anesthesia combined with scalp nerve block and intercostal nerve block with 0.5% ropivacaine, which was performed exclusively by an attending anesthesiologist.An attending anesthesiologist will select the site of SNB based on the surgical incision site. Scalp nerve was blocked including greater occipital nerve (2-3ml), superficial temporal nerve (2-3ml), trochlear nerve (2-3ml) and supraorbital nerve (2-3ml). The total volume in scalp nerve block will not exceed 10 ml.Ultrasound-guided unilateral ICNB will be performed at the level of T4-T5 next to the sternum.10-15ml of 0.5% ropivacaine will be injected into the intercostal spaces where incision locates after negative aspiration.<br>|
| No Intervention: control group<br>patients in control group will receive general anesthesia without nerve block. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The 15-item QoR score | The 15-item QoR score is used to asses quality of recovery after surgery which ranges 0-150 and higher QoR-15 scores indicate better postoperative recovery | 24 hour after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The 15-item QoR score | The 15-item QoR score is used to asses quality of recovery after surgery which ranges 0-150 and higher QoR-15 scores indicate better postoperative recovery | 72 hour and 1 month after surgery | 
| The NRS score | Postoperative pain will be quantified using the NRS ranging from 0 to 10, where 0 means no pain at all and 10 means the worst pain imaginable | before discharge from PACU, at 24 hour, 72 hour and 1 month after surgery | 
| The patients with PONV | postoperative nausea and vomiting | 24 hour after surgery | 
| Consumption of opioid | The consumption of opioid reffers to remifentanil consumption | during operation |