Background: The purpose of this study was to compare the effects of scalp nerve block (SNB) and local anesthetic\ninfiltration (LA) with 0.75% ropivacaine on postoperative inflammatory response, intraoperative hemodynamic\nresponse, and postoperative pain control in patients undergoing craniotomy.\nMethods: Fifty-seven patients were admitted for elective craniotomy for surgical clipping of a cerebral aneurysm.\nThey were randomly divided into three groups: Group S (SNB with 15 mL of 0.75% ropivacaine), group I (LA with 15\nmL of 0.75% ropivacaine) and group C (that only received routine intravenous analgesia). Pro-inflammatory cytokine\nlevels in plasma for 72 h postoperatively, hemodynamic response to skin incision, and postoperative pain intensity\nwere measured.\nResults: The SNB with 0.75% ropivacaine not only decreased IL-6 levels in plasma 6 h after craniotomy but also\ndecreased plasma CRP levels and increased plasma IL-10 levels 12 and 24 h after surgery compared to LA and\nroutine analgesia. There were significant increases in mean arterial pressure 2 and 5 mins after the incision and\nduring dura opening in Groups I and C compared with Group S. Group S had lower postoperative pain intensity,\nlonger duration before the first dose of oxycodone, less consumption of oxycodone and lower incidence of PONV\nthrough 48 h postoperatively than Groups I and C.\nConclusion: Preoperative SNB attenuated inflammatory response to craniotomy for cerebral aneurysms, blunted\nthe hemodynamic response to scalp incision, and controlled postoperative pain better than LA or routine analgesia.
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