ArticlePakistan journal of medical sciences2026
Perioperative analgesic management using conventional versus regional nerve block in craniotomy surgeries in lower middle-income countries.
Article in Pakistan journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This study's primary objective was to assess the efficacy of systemic opioids with pre-incision bilateral scalp nerve block for supratentorial craniotomy pain via intraoperative hemodynamic variables at different intervals. The secondary objective was to assess the postoperative pain, rescue analgesia requirement, sedation, nausea and vomiting in first 24 hours of surgery. Methodology: This double-blinded randomized controlled trial, conducted at Aga Khan University Hospital, Karachi. The 62 adult patients (ASA I-III), recruited for elective supratentorial craniotomy via randomization into two groups (n=31/group). Group-M received intravenous morphine (0.1 mg/kg) at induction. Group-S received bilateral SNB with lidocaine, ropivacaine, adrenaline, and dexamethasone. The heart rate, systolic, diastolic, and mean arterial pressures were recorded at predefined intraoperative intervals. Postoperatively, both participants received PCIA morphine, and pain was assessed by visual analogue scale (VAS), along with sedation, nausea and vomiting incidences, which were recorded in first 24 hours at various intervals. Results: The demographic and surgical characteristics were insignificant in both groups ( Conclusion: Pre-incisional scalp nerve block provides better attenuation of intraoperative noxious stimuli via hemodynamic control, and it shows superior postoperative analgesia, without risking the sedation, nausea and vomiting in supratentorial craniotomy surgeries.
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