Viewing Study NCT03177252



Ignite Creation Date: 2024-05-06 @ 10:09 AM
Last Modification Date: 2024-10-26 @ 12:25 PM
Study NCT ID: NCT03177252
Status: WITHDRAWN
Last Update Posted: 2020-10-22
First Post: 2017-05-08

Brief Title: Scalp Block Hemodynamic Stability and Patient Comfort In Craniotomy Patients
Sponsor: Washington University School of Medicine
Organization: Washington University School of Medicine

Study Overview

Official Title: Scalp Block Hemodynamic Stability and Patient Comfort In Craniotomy Patients
Status: WITHDRAWN
Status Verified Date: 2020-10
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Investigator decided not to go forward with the trial
Has Expanded Access: False
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: Scalp block
Brief Summary: Making sure the heart rate and or the blood pressure called hemodynamic instability during surgery is stable setting up for a rapid postoperative recovery and ensuring that patients have adequate pain relief are some of the important goals of neurosurgical anesthesia Scalp block anesthesia injection of a numbing agent into the area of the scalp where the incision will be together with general anesthesia is used to achieve these goals There has been some research on whether or not scalp block improves patient recovery and pain management but the studies have not be large enough to say for certain This is true even though scalp block is used with almost every patient that is having brain surgery The investigators propose to determine if scalp block in combination with asleep anesthesia is better than asleep anesthesia alone in patients who are having brain surgery for tumors in the cerebral area of the brain
Detailed Description: Avoidance of hemodynamic fluctuations in the heart rate and or the blood pressure perioperatively rapid postoperative recovery and adequate postoperative pain relief are some of the important goals of neurosurgical anesthesia Scalp block in association with general anesthesia is used to achieve these goals Previous studies have been published related to the effect of scalp block on the perioperative outcomes on the craniotomy patients The results reported so far are controversial and one cannot at this point define a positive effect for post-operative pain relief This disparity in results may be the consequences of the size of the patient population However scalp block is an accepted practice in the craniotomy patients The investigators believe this is the first study which assesses the effectiveness of scalp block for asleep craniotomy with the largest sample size study so far conducted in the literature related to this topic The aim of this study is to assess the effectiveness of scalp block for the perioperative comfort of the craniotomy patients undergoing resection for supratentorial tumors

After the consent for the participation and enrollment in the study is done patients will be randomized to two groups a study group will receive a scalp block with a mixture of 2 lidocaine and 05 bupivacaine while the control group will receive the scalp block with saline Intraoperatively all patients will be preoxygenated fentanyl 1-2mcgkg will be given and anesthesia will be induced with propofol 1-2mgkg and lidocaine 1-15mgkg Tracheal intubation will be facilitated by using either rocuronium 06 mgkg or succinylcholine 1-15mgkg intravenously The lungs will be ventilated with a fresh gas flow of oxygen for 2 minutes before tracheal intubation with cuffed oral endotracheal tube Anesthesia will be maintained with inhalational anesthetic Isoflurane Sevoflurane or Desflurane 08-1 MAC and fentanyl infusion 1-2mcgkg with the dose adjusted according to the patients hemodynamics Bilateral BIS or EEG to maintain an adequate level of depth of anesthesia will be used whenever feasible After intubation a scalp block will be performed The randomization of the scalp block syringes will be provided by the pharmacy and neither the scalp block performer nor the attending will be aware of the syringe content To standardize the block a pain specialist is involved Response to the pinning will be assessed using the hemodynamic parameters and rescue analgesics fentanyl bolus 50 - 100 mcg andor propofol bolus 50 - 100 mg will be given as a bolus if significant response is noted Significant response being a rise in the patients heart rate andor the blood pressure more than 20 from the patients baseline heart rate andor the blood pressure just before pinning Similarly response to the surgical incision will be noted and rescue analgesics will be given if needed Intraoperative propofol requirement and opioid requirements will be recorded The post-operative orders for pain control will be standardized for all the patients

Study Oversight

Has Oversight DMC: None
Is a FDA Regulated Drug?: True
Is a FDA Regulated Device?: False
Is an Unapproved Device?: None
Is a PPSD?: None
Is a US Export?: False
Is an FDA AA801 Violation?: None