Epilepsy Clinical Trial
Official title:
Effect of Bilateral Scalp Nerve Blocks on Post-operative Pain and Discharge Times in Patients Undergoing Supra-tentorial Craniotomy and General Anaesthesia
The objective of this study is to demonstrate that scalp nerve blocks ("scalp freezing"), performed at the end of supratentorial brain surgery, will reduce post-operative pain, opioids side effects, and the time required for post-anaesthesia care unit (PACU)/Intensive Care Unit (ICU) and hospital discharge.
Status | Completed |
Enrollment | 89 |
Est. completion date | December 2011 |
Est. primary completion date | October 2011 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - adults aged 18 years and over; - patients scheduled for elective craniotomy under general anaesthesia for one of the following surgeries: - resection of a supratentorial brain tumour, - clipping of an un-ruptured supratentorial cerebral aneurysm, - excision of a supratentorial arterio-venous malformation (AVM), - removal of an epileptic focus under general anaesthetic. - ASA physical status < IV. Exclusion Criteria: - history of significant coronary artery disease (NYHA class III or IV) which would contraindicate the use of epinephrine; - presence of pain related to the intracranial pathology (e.g. tumour pain) since it could make difficult the discrimination between the tumour pain itself and the surgery related pain; - current history of alcohol abuse or recreational drug abuse; - active psychotic disorder; - history of chronic pain requiring chronic opioids use (patients on opioids for > 2 weeks); - known or suspected addiction to narcotic substances; - presence of any acute distracting pain; - history of migraines; - inability to understand or incapacity to use the VAS; - proven or suspected allergy to local anaesthetics; - craniotomy incision extending beyond the field of the block; - predicted need for postoperative ventilation; - history of scalp paresthesia or scalp scarring that may preclude normal nerve anatomy; - previous craniotomy or cranial irradiation; - history of malignant hyperthermia, which would contraindicate the anaesthesia maintenance protocol of this study; - pregnancy. |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Canada | St. Michael's Hospital | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
St. Michael's Hospital, Toronto | The Physicians' Services Incorporated Foundation |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The primary outcome will be the 24h post-operative VAS score among adults undergoing supratentorial craniotomy. | 24 hours | No | |
Secondary | 48h post-operative pooled VAS score | 48 hours | No | |
Secondary | the total PCA hydromorphone consumption in the first at 24 and 48 post-operative hours | 24 and 48 hours | No | |
Secondary | total hydromorphone demands and delivered doses in the first 24 and 48 post-operative hours | 24 and 48 hours | No | |
Secondary | the incidence of nausea and vomiting in the first 24 and 48 post-operative hours | 24 and 48 hours | No | |
Secondary | the time for patients to reach discharge eligibility from the PACU/ICU | Discharge time and date from PACU/ICU | No | |
Secondary | the time for patients to reach discharge eligibility from hospital | Discharge time and date from hospital | No | |
Secondary | presence of long term pain as measured with the Numeric Rating Scale (NRS) at days 5, 30 and 60 postoperatively | 5, 30 and 60 days | No | |
Secondary | Karnofsky Performance Scale Index and modified pain treatment satisfaction scale (PTSS) at day 5 | day 5 | No |
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