Scalp block for awake craniotomy: Lidocaine-bupivacaine versus lidocaine-bupivacaine with adjuvants

Figures & data

Figure 1. A drawing for the main branches responsible for the cutaneous sensory innervations of the forehead and scalp

Table 1. Ramsay sedation scale [23]

Score	Response
1	Anxious or restless or both
2	Cooperative, oriented and tranquil (calm)
3	Responding to command
4	Brisk (quick) response to stimulus
5	Sluggish (slow moving) response to stimulus
6	No response to stimulus

Figure 2. Flow chart of the study

Table 2. Patients’ characteristics and surgical data

Variable	Group I (n = 10)	Group II (n = 10)	Group III (n = 10)	Group IV (n = 10)	P value
Age (y)	33 (22–48)	34 (30–47)	31 (23–44)	34 (25–47)	0.643
BMI (kg/m^2)	27.6 ± 1.2	27.1 ± 1.4	28.3 ± 1.5	28.1 ± 1.1	0.187
Sex: Male/Female (n)	6/4	7/3	5/5	8/2	0.523
ASA II/III (n)	9/1	7/3	6/4	8/2	0.446
Surgical data
Side of the tumor (right/left)	4/6	5/5	3/7	4/6	0.841
Duration of surgery (min)	207.1 ± 15	203.8 ± 19	206.5 ± 16	208.2 ± 11	0.932
Duration of recovery from sedation by the end of surgery (min)	22.5 ± 0.7	21.1 ± 1.1	20.3 ± 0.8	21.6 ± 0.9	0.955

p value was considered statistically significant when <0.05. Data are represented as median (range), mean ± SD, or number.

BMI: body mass index. ASA: American Society of Anesthesiologists.

Table 3. Analgesic performance in the four groups of the study

Variable	Group I (n = 10)	Group II (n = 10)	Group III (n = 10)	Group IV (n = 10)	P value
Total intraoperative consumption of propofol/patient (mg)	104 ± 18	100 ± 13	98 ± 16	94 ± 10	0.493
Total intraoperative consumption of dexmedetomidine/patient (µg)	286 ± 27	232 ± 21**	241 ± 18**	162 ± 25^§§	<0.001
Time to first paracetamol requirement (min): VAS ≥4	187 ± 17	245 ± 32**	236 ± 28**	388 ± 14^§§	<0.001
Total consumption of paracetamol in POD1/patient (g)	2.9 ± 0.4	2.7 ± 0.3	2.8 ± 0.5	2.2 ± 0.1^§§	<0.001

p value was considered statistically significant when <0.05 and highly statistically significant when <0.001.

Data are represented as mean ±SD.

** Highly statistically significant difference when compared to Group I.

§§ Highly statistically significant difference when compared to the other three groups.

VAS: visual analog scale.

Table 4. Blood glucose level (mg/dL) in the four groups of the study

Variable	Group I (n = 10)	Group II (n = 10)	Group III (n = 10)	Group IV (n = 10)	P value
Just before scalp block	95.1 ± 4.2	97.3 ± 3.3	98.9 ± 5.7	96.1 ± 5.1	0.313
2 h after scalp block	93.3 ± 6.1	95.4 ± 5.2	97.7 ± 3.9	96.8 ± 4.1	0.224
4 h after scalp block	98.1 ± 2.2	96.6 ± 5.3	97.1 ± 4.3	95.1 ± 4.7	0.476
6 h after scalp block	95.8 ± 3.9	94.9 ± 3.7	96.2 ± 4.6	94.5 ± 5.2	0.811

p value was considered statistically significant when <0.05 and highly statistically significant when <0.001.

Data are represented as mean ±SD.

Figure 3. Degree of pain during the first postoperative day (POD1) according to visual analog scale [25] (VAS) in the four groups of the study. Data were presented by median and range

Figure 4. Intraoperative changes in MAP (mmHg) in the four groups of the study

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