Article: Scalp nerve blockade reduces pain after headframe placement in radiosurgery: a double blind, randomized clinical trial.
Middle East journal of anaesthesiology
2013 Volume 22, Issue 1, Page(s) 79–85
Abstract: Background: Patients undergoing stereotactic headframe placement for radiosurgery report that discomfort associated with the headframe often lasts for the duration of the treatment day (approximately 6 hours). We hypothesize that blockade of scalp ... ...
| Abstract | Background: Patients undergoing stereotactic headframe placement for radiosurgery report that discomfort associated with the headframe often lasts for the duration of the treatment day (approximately 6 hours). We hypothesize that blockade of scalp nerves prior to headframe placement reduces the incidence of moderate to severe head pain during the entire treatment day. We describe a randomized, double-blind, placebo-controlled study of awake patients having radiosurgery for intracranial pathology that examines whether scalp nerve blockade and local anesthetic infiltration results in superior patient comfort versus infiltration alone. Methods: Twenty seven adult patients undergoing stereotactic radiosurgery were randomized to receive a nerve block with placebo or bupivacaine 0.5% with epinephrine. Supraorbital and greater occipital nerve blocks using blinded syringes were performed by the anesthesiologist in addition to subcutaneous infiltration of pin sites with lidocaine 1% by the surgeon. Pain was reported using 10 cm visual analog scales (VAS) at pre-specified time points during the treatment day. The primary outcome measure was the presence of pain scores classified as "zero to mild pain (VAS <4)" or "moderate to severe pain (VAS > or = 4)". Results: 27 patients were randomized to placebo (n = 14) and nerve block (n = 13) groups. The proportion of moderate to severe pain measurements were significantly less in the nerve block group than the placebo group (4.9% vs. 24.1%; odds ratio, 0.166; 95% confidence interval 0.029-0.955; p = 0.044). There were no adverse events. Conclusion: Scalp nerve block significantly decreased moderate to severe head pain in radiosurgery patients throughout the treatment day. |
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| MeSH term(s) | Adult ; Aged ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Nerve Block ; Pain Measurement ; Pain, Postoperative/prevention & control ; Radiosurgery ; Scalp/innervation | |||||
| Language | English | |||||
| Publishing date | 2013-02 | |||||
| Publishing country | Lebanon | |||||
| Document type | Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 442030-5 | |||||
| ISSN | 0544-0440 | |||||
| ISSN | 0544-0440 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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