This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Ayoub, C. Articles by Moumdjian, R. Search for Related Content PubMed PubMed Citation Articles by Ayoub, C. Articles by Moumdjian, R. Related Collections Neuroanesthesia Regional Anesthesia

---

NEUROSURGICAL ANESTHESIA

A Comparison Between Scalp Nerve Block and Morphine for Transitional Analgesia After Remifentanil-Based Anesthesia in Neurosurgery

Christian Ayoub, MD, B. Pharm^*, François Girard, MD, FRCPC^*, Daniel Boudreault, MD, FRCPC^*, Philippe Chouinard, MD, FRCPC^*, Monique Ruel, RN^*, and Robert Moumdjian, MD, FRCS(C)

From the *Department of Anesthesiology, and Neurosurgery division, CHUM, Hôpital Notre-Dame, Montréal, Canada.

Address correspondence and reprint requests to François Girard MD, FRCPC, Department of Anesthesiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke East, Montreal, Canada, H2L 4M1. Address e-mail to francois.girard.chum{at}ssss.gouv.qc.ca.

We compared transitional analgesia provided by scalp nerve block (SNB) or morphine after remifentanil-based anesthesia in neurosurgery. Fifty craniotomy patients were randomly divided into two groups: morphine (morphine 0.1 mg · kg^–1 IV after dural closure and an SNB performed with 20 mL of 0.9% saline at the end of surgery) and block (10 mL of 0.9% saline instead of morphine after dural closure and an SNB performed with a 1:1 mixture of bupivacaine 0.5% and lidocaine 2% at the end of surgery). Postoperative pain was assessed at 1, 2, 4, 8, 12, 16, and 24 h using a 10-point numerical rating scale. Analgesia consisted of subcutaneous codeine. Average numerical rating scale scores were similar between the two groups at each time interval. Total codeine dosage was also similar, except at 4 h postoperatively when it was higher in the block group. The delay before administration of the first dose of codeine was not statistically different between groups: 45 min (20–2880) vs 30 min (10–2880), median and range for the block and morphine group, respectively. Postoperative hemodynamics were similar for both groups. The incidence of nausea and vomiting was slightly more frequent in the morphine group, but the occurrence of confusion did not differ between groups. In conclusion, SNB provides a quality of transitional analgesia that is similar to that of morphine with the same postoperative hemodynamic profile.

This article has been cited by other articles:

				H. Batoz, O. Verdonck, C. Pellerin, G. Roux, and P. Maurette The Analgesic Properties of Scalp Infiltrations with Ropivacaine After Intracranial Tumoral Resection Anesth. Analg., July 1, 2009; 109(1): 240 - 244. [Abstract] [Full Text] [PDF]