title: Effect of scalp blocks with levobupivacaine on recovery profiles after craniotomy for aneurysm clipping: a randomized, double-blind, and controlled study.
abstract: OBJECTIVE
  This study was conducted to evaluate the effect of scalp blocks using levobupivacaine on recovery profiles including postoperative pain, patient-controlled analgesia (PCA) consumption, postoperative nausea and vomiting (PONV), and other adverse events in patients undergoing frontoparietal craniotomy for aneurysm clipping.
  
  
  METHODS
  Fifty-two patients scheduled for elective frontoparietal craniotomy for unruptured aneurysm clipping were enrolled. After surgery, scalp blocks were performed using normal saline (group C, n = 26) or 0.75% levobupivacaine (group L, n = 26). Postoperative pain scores and PCA consumption were recorded for 72 hours after recovery of consciousness. The time from patient recovery to the first use of PCA drug and rescue analgesics, the requirement for vasoactive agents, and adverse effects related to PCA and local anesthetics also were recorded.
  
  
  RESULTS
  Postoperative pain scores and PCA consumption in group L were lower than in group C (P < .05). The time intervals from patient recovery to the first use of PCA drug (P < .001) and rescue analgesics (P = .038) was longer in group L than in group C. Additionally, less antihypertensive agent was required (P = .017), and PONV occurred less frequently (P = .039) in group L than in group C.
  
  
  CONCLUSIONS
  Scalp blocks with 0.75% levobupivacaine improved recovery profiles in that it effectively lowered postoperative pain and PCA consumption without severe adverse events and also reduced the requirement for a postoperative antihypertensive agent and the incidence of PONV in patients who underwent frontoparietal craniotomy for aneurysm clipping.
authors.affiliation: Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Jae-Seung
authors.initials: JS
authors.lastname: Bang
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Chang-Wan
authors.initials: CW
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Jin-Deok
authors.initials: JD
authors.lastname: Joo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Seong-Joo
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Sang-Hwan
authors.initials: SH
authors.lastname: Do
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Yong-Jae
authors.initials: YJ
authors.lastname: Yoo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea. Electronic address: jinaryu@lycos.co.kr.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000031:analogs & derivatives*; D003399:Craniotomy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D012535:Scalp
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Analgesia; Aneurysm; Levobupivacaine; Local anesthetics; Postoperative; Regional blockade; Surgery