Scalp block versus subcutaneous infiltration for stereotactic brain biopsy: a randomized controlled trial

Abstract

Objective The aim of the current study was to compare scalp block and subcutaneous infiltration anesthesia in adult patient during the placement of a stereotactic head frame and taking brain biopsy. Patients and methods The current randomized controlled trial was conducted at the Neurosurgery Department in Ain Shams University Hospitals on patients who were scheduled for stereotactic brain biopsy. The recruited patients were randomly allocated into one of two groups: group A had 40 patients who received subcutaneous infiltration anesthesia and group B included 40 patients who received scalp nerve block. Both groups were compared regarding analgesic efficacy, hemodynamic changes, duration of local anesthetic, need of supplementary subcutaneous injections, need for postoperative analgesia, and postoperative complications. Results A total of 80 patients were recruited in the current trial. The mean values of the 10-cm visual analogue scale for assessment of pain was significantly lower in patients of group B when compared with patients of group A. Conclusion Scalp block with 0.5% bupivacaine reduced pain, heart rate, and mean arterial pressure response during the fixation of stereotaxy frame, the skin incision, and biopsy intake, and it also decreased the need for more local infiltration in comparison with the use of local subcutaneous infiltration. Moreover, the pain intensity was lower after scalp block in the early postoperative period with less incidence of headache in postoperative period.