Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial
Context: Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2018-01-01
|
Series: | Journal of Neurosciences in Rural Practice |
Subjects: | |
Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/jnrp.jnrp_310_17 |
id |
doaj-a0d0dcd704f3439e8064daddbfb8e965 |
---|---|
record_format |
Article |
spelling |
doaj-a0d0dcd704f3439e8064daddbfb8e9652021-04-02T10:55:44ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neurosciences in Rural Practice0976-31470976-31552018-01-01090107307910.4103/jnrp.jnrp_310_17Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized TrialShankar Vallapu0Nidhi Bidyut Panda1Navneh Samagh2Neerja Bharti3Consultant Critical Care Medicine Simhapuri Hospitals NH5 Chintareddypalem Cross Roads Nellore, Andhra Pradesh, IndiaDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Anaesthesia and Intensive Care, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, IndiaDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaContext: Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare the two techniques. Aims: The primary objective was to assess whether addition of dexmedetomidine to bupivacaine prolonged the duration of analgesia. The secondary objective was to compare between scalp nerve block and scalp infiltration as techniques for pain relief. Settings and Design: The randomized control study was conducted in a tertiary care center from November 2013 to October 2014. Materials and Methods: A total of 150 American Society of Anesthesiologists Physical Status I–II patients, aged 18–70 years undergoing elective craniotomy were included. Patients were randomized into three groups of 50 patients, i.e., Group BI (bupivacaine infiltration), Group BDI (bupivacaine and dexmedetomidine infiltration), and Group BDNB (bupivacaine and dexmedetomidine scalp nerve block). Patient's pain score, pain-free interval, rescue analgesic requirement, and hemodynamic and respiratory parameters were noted for 48 h. Patients were followed up at 1 and 3 months to assess postcraniotomy pain. Results: Pain-free period was significantly longer in Group BDNB than Groups BDI and BI (P < 0.0001) and pain control was better in dexmedetomidine containing groups than in bupivacaine group (BI) (P < 0.0001). The rescue analgesic requirement was significantly lower in Group BDNB and Group BDI compared to Group BI. Conclusion: The addition of dexmedetomidine (1 µg/kg) to bupivacaine prolonged the pain-free period. Scalp nerve block is a superior technique than scalp infiltration.http://www.thieme-connect.de/DOI/DOI?10.4103/jnrp.jnrp_310_17 dexmedetomidine postcraniotomy pain scalp nerve block |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shankar Vallapu Nidhi Bidyut Panda Navneh Samagh Neerja Bharti |
spellingShingle |
Shankar Vallapu Nidhi Bidyut Panda Navneh Samagh Neerja Bharti Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial Journal of Neurosciences in Rural Practice dexmedetomidine postcraniotomy pain scalp nerve block |
author_facet |
Shankar Vallapu Nidhi Bidyut Panda Navneh Samagh Neerja Bharti |
author_sort |
Shankar Vallapu |
title |
Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial |
title_short |
Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial |
title_full |
Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial |
title_fullStr |
Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial |
title_full_unstemmed |
Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial |
title_sort |
efficacy of dexmedetomidine as an adjuvant to local anesthetic agent in scalp block and scalp infiltration to control postcraniotomy pain: a double-blind randomized trial |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Journal of Neurosciences in Rural Practice |
issn |
0976-3147 0976-3155 |
publishDate |
2018-01-01 |
description |
Context: Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare the two techniques. Aims: The primary objective was to assess whether addition of dexmedetomidine to bupivacaine prolonged the duration of analgesia. The secondary objective was to compare between scalp nerve block and scalp infiltration as techniques for pain relief. Settings and Design: The randomized control study was conducted in a tertiary care center from November 2013 to October 2014. Materials and Methods: A total of 150 American Society of Anesthesiologists Physical Status I–II patients, aged 18–70 years undergoing elective craniotomy were included. Patients were randomized into three groups of 50 patients, i.e., Group BI (bupivacaine infiltration), Group BDI (bupivacaine and dexmedetomidine infiltration), and Group BDNB (bupivacaine and dexmedetomidine scalp nerve block). Patient's pain score, pain-free interval, rescue analgesic requirement, and hemodynamic and respiratory parameters were noted for 48 h. Patients were followed up at 1 and 3 months to assess postcraniotomy pain. Results: Pain-free period was significantly longer in Group BDNB than Groups BDI and BI (P < 0.0001) and pain control was better in dexmedetomidine containing groups than in bupivacaine group (BI) (P < 0.0001). The rescue analgesic requirement was significantly lower in Group BDNB and Group BDI compared to Group BI. Conclusion: The addition of dexmedetomidine (1 µg/kg) to bupivacaine prolonged the pain-free period. Scalp nerve block is a superior technique than scalp infiltration. |
topic |
dexmedetomidine postcraniotomy pain scalp nerve block |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/jnrp.jnrp_310_17 |
work_keys_str_mv |
AT shankarvallapu efficacyofdexmedetomidineasanadjuvanttolocalanestheticagentinscalpblockandscalpinfiltrationtocontrolpostcraniotomypainadoubleblindrandomizedtrial AT nidhibidyutpanda efficacyofdexmedetomidineasanadjuvanttolocalanestheticagentinscalpblockandscalpinfiltrationtocontrolpostcraniotomypainadoubleblindrandomizedtrial AT navnehsamagh efficacyofdexmedetomidineasanadjuvanttolocalanestheticagentinscalpblockandscalpinfiltrationtocontrolpostcraniotomypainadoubleblindrandomizedtrial AT neerjabharti efficacyofdexmedetomidineasanadjuvanttolocalanestheticagentinscalpblockandscalpinfiltrationtocontrolpostcraniotomypainadoubleblindrandomizedtrial |
_version_ |
1724166342390579200 |