Related Experiment Video
Updated: Jun 20, 2026
14:59
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Scalp nerve blocks for external ventricular drainage placement in children
Hande Gurbuz1, Elif Basaran Gundogdu2, Derya Karasu3
1Department of Anesthesiology and Reanimation, Bursa School of Medicine, Bursa City Hospital, University of Health Sciences, Bursa, 16110, Türkiye. handegrbz@gmail.com.
BMC Anesthesiology
|June 19, 2026
Summary
Scalp nerve blocks (SNB) with sedation offer a safer alternative to general anesthesia for pediatric external ventricular drainage (EVD) placement. This method reduced pain responses and analgesic needs, preserving spontaneous ventilation.
Area of Science:
- Pediatric Anesthesiology
- Neurosurgery
- Pain Management
Background:
- External ventricular drainage (EVD) placement in pediatric patients typically requires general anesthesia, posing risks like airway instability.
- Scalp nerve blocks (SNB) with sedation present a potential alternative, aiming to mitigate risks associated with general anesthesia.
- SNB may also reduce the need for postoperative pain medication compared to traditional incision-site infiltration.
Purpose of the Study:
- To compare perioperative outcomes of EVD placement in pediatric patients using SNB with sedation versus general anesthesia with incision-site infiltration.
- To evaluate the efficacy and safety of SNB as a primary anesthetic technique for EVD procedures.
- To assess differences in analgesic requirements, hemodynamic responses, and need for anesthesia conversion.
Main Methods:
- A prospective observational study analyzing 63 EVD placements in children under 8 years old.
- Patients were divided into two groups: SNB with sedation (n=29) and general anesthesia with incision-site infiltration (n=34).
- Key outcomes measured included postoperative analgesic needs, total analgesic consumption, heart rate response to incision, and conversion rates to general anesthesia.
Main Results:
- SNB significantly reduced heart rate response to surgical stimulus compared to incision-site infiltration (3.4% vs. 73.5%, p<0.001).
- Patients receiving SNB required significantly less postoperative analgesia and had lower total consumption in the first 24 hours (p<0.001).
- No procedures under SNB required conversion to general anesthesia, and intraoperative opioid use was lower.
Conclusions:
- Scalp nerve blocks combined with sedation are a feasible alternative to general anesthesia for pediatric EVD placement.
- SNB demonstrated reduced nociceptive responses, lower postoperative analgesic requirements, and decreased intraoperative opioid use.
- This technique effectively preserved spontaneous ventilation, enhancing patient safety during EVD procedures.
