Combined Betamethasone and Ropivacaine for Scalp Nerve Block for Patients Undergoing Elective Craniotomy: A...

Area of Science:

• Neurosurgery
• Anesthesiology
• Pain Management

Background:

• Scalp nerve block (SNB) is crucial for neurosurgical recovery but offers limited pain relief with local anesthetics alone.
• The combination of betamethasone and ropivacaine is explored for extended analgesia post-craniotomy.

Purpose of the Study:

• To evaluate if combining betamethasone with ropivacaine in SNB prolongs postoperative analgesia compared to ropivacaine alone.
• To assess the impact of this combination on pain scores and inflammatory markers.

Main Methods:

• A prospective, randomized controlled trial involving 90 patients undergoing elective craniotomy.
• Patients received SNB with either 0.5% ropivacaine plus betamethasone or 0.5% ropivacaine alone.
• Primary outcome: Numerical Rating Scale (NRS) pain score at 48 hours postoperatively; Secondary outcomes: NRS scores within 48 hours and plasma cytokine levels (IL-6, IL-10, IFN-γ).

Main Results:

• The betamethasone group showed significantly lower NRS pain scores at 48 hours (1 vs 2, P<0.001) and improved scores within 24 hours.
• Lower concentrations of interleukin-6 (P=0.001) and interferon-gamma (P=0.042) were observed in the betamethasone group.
• No significant difference in interleukin-10 levels was found between groups (P=0.582).

Conclusions:

• Betamethasone combined with 0.5% ropivacaine SNB effectively reduces postoperative pain intensity at 48 hours and within 24 hours.
• The enhanced analgesia is likely attributed to prolonged anesthetic effects and a reduction in the inflammatory response.