Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Effects of Scalp Nerve Block on the Quality of Recovery after Minicraniotomy for Clipping of Unruptured Intracranial Aneurysms : A Randomized Controlled Trial

  • Seungeun Choi (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Young Hoon Choi (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hoo Seung Lee (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kyong Won Shin (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yoon Jung Kim (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hee-Pyoung Park (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Won-Sang Cho (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hyongmin Oh (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2023.01.11
  • Accepted : 2023.04.10
  • Published : 2023.11.01
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Abstract

Objective : This study compared the quality of recovery (QoR) after minicraniotomy for clipping of unruptured intracranial aneurysms (UIAs) between patients with and without scalp nerve block (SNB). Methods : Patients were randomly assigned to the SNB (SNB using ropivacaine with epinephrine, n=27) and control (SNB using normal saline, n=25) groups. SNB was performed at the end of surgery. To assess postoperative QoR, the QoR-40, a patient-reported questionnaire, was used. The QoR-40 scores were measured preoperatively, 1-3 days postoperatively, at hospital discharge, and 1 month postoperatively. Pain and intravenous patient-controlled analgesia (IV-PCA) consumption were evaluated 3, 6, 9, and 12 hours and 1-3 days postoperatively. Results : All QoR-40 scores, including those measured 1 day postoperatively (primary outcome measure; 155.0 [141.0-176.0] vs. 161.0 [140.5-179.5], p=0.464), did not significantly differ between the SNB and control groups. The SNB group had significantly less severe pain 3 (numeric rating scale [NRS]; 3.0 [2.0-4.0] vs. 5.0 [3.5-5.5], p=0.029), 9 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.048), and 12 (NRS; 3.0 [2.0-4.0] vs. 4.0 [3.0-5.0], p=0.035) hours postoperatively. The total amount of IV-PCA consumed was significantly less 3 hours postoperatively in the SNB group (2.0 [1.0-4.0] vs. 4.0 [2.0-5.0] mL, p=0.044). Conclusion : After minicraniotomy for clipping of UIAs, SNB reduced pain and IV-PCA consumption in the early postoperative period but did not improve the QoR-40 scores.

Keywords

Acknowledgement

This study was presented as an abstract from KNS 2022 (October 8, 2022, Songdo Convensia Incheon, Korea). This work was supported by a grant (number : 1120215060) from the SNUH Research Fund.

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