Clinical trial · Interventional
Comparison of Systemic Opioid (Morphine) and Pre-Incision Bilateral Scalp Nerve Block for Pain Management in Craniotomy Patients
Perioperative Analgesic Management Using Conventional Versus Regional Nerve Block in Craniotomy Surgeries in Lower Middle-Income Class Countries
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
The goal of this randomized controlled clinical trial is to compare the effectiveness of systemic opioids versus pre-incision bilateral scalp nerve block in managing intraoperative noxious stimuli and postoperative pain in adult patients (18-75 years) undergoing elective supratentorial craniotomy. The main questions this study aims to answer are: Does pre-incision bilateral scalp nerve block provide better intraoperative hemodynamic stability compared to systemic opioids? Does it result in lower postoperative pain scores and reduced opioid consumption during the first 24 hours after surgery? Researchers will compare Group M (systemic morphine) with Group S (bilateral scalp nerve block) to see if the scalp nerve block offers superior analgesia and fewer opioid-related side effects. Participants will: Be randomly assigned to receive either systemic morphine or bilateral scalp nerve block before incision. Undergo standard general anesthesia for craniotomy. Have postoperative pain managed using a patient-controlled analgesia (PCA) morphine pump and be monitored for 24 hours for pain, sedation, and nausea/vomiting scores
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Supratentorial Tumors | Supratentorial Neoplasm | ALIAS | 0.90 |
Interventions
Interventions (6)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Dexamethasone | Drug | Dexamethasone | ALIAS |
| Epinephrine (Adrenaline) | Drug | — | UNRESOLVED |
| Lidocaine | Drug | — | UNRESOLVED |
| Morphine | Drug | — | UNRESOLVED |
| Ropivacaine | Drug | — | UNRESOLVED |
| Scalp nerve block | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- ACTIVE_COMPARATOR
- label
- Intravenous Morphine
- description
- Participants receive intravenous Morphine 0.1mg/kg at induction.
- interventionNames
- Drug: Morphine
- type
- EXPERIMENTAL
- label
- Bilateral Scalp Nerve Block (SNB)
- description
- Participants receive a bilateral scalp nerve block after arterial line insertion using local anesthetic agents with adjuvants.
- interventionNames
- Procedure: Scalp nerve block
- Drug: Lidocaine
- Drug: Ropivacaine
- Drug: Epinephrine (Adrenaline)
- Drug: Dexamethasone
Primary outcomes (4)
- measure
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
- Maximum age
- 75 Years
Show eligibility criteria text
Inclusion Criteria: * Age 18 years to 75 years, * American Society of Anesthesiologists class I-III, * Scheduled for supratentorial craniotomy. Exclusion Criteria: * Patient with Glasgow Coma Score (GCS) of less than 15, * Inability to understand the Visual analog scale (VAS) * Allergic to study drugs (Morphine and local anesthetics) * Patient chronically treated with narcotic medications. * History of Liver dysfunction
References
Publications (5)
- BACKGROUNDDilmen OK, Akcil EF, Tunali Y, Karabulut ES, Bahar M, Altindas F, Vehid H, Yentur E. Postoperative analgesia for supratentorial craniotomy. Clin Neurol Neurosurg. 2016 Jul;146:90-5. doi: 10.1016/j.clineuro.2016.04.026. Epub 2016 May 4. PMID 27164511
- BACKGROUNDJayaram K, Srilata M, Kulkarni D, Ramachandran G. Regional Anesthesia to Scalp for Craniotomy: Innovation With Innervation. J Neurosurg Anesthesiol. 2016 Jan;28(1):32-7. doi: 10.1097/ANA.0000000000000184. PMID 26083426
- BACKGROUNDTuchinda, Lawan & Somboonviboon, Wanna & Supbornsug, Kaew & Worathongchai, Sukhumakorn & Limutaitip, Supodjanee. (2010). Bupivacaine scalp nerve block: Hemodynamic response during craniotomy, intraoperative and post-operative analgesia. Asian Biomedicine. 4. 10.2478/abm-2010-0031.
- BACKGROUNDNguyen A, Girard F, Boudreault D, Fugere F, Ruel M, Moumdjian R, Bouthilier A, Caron JL, Bojanowski MW, Girard DC. Scalp nerve blocks decrease the severity of pain after craniotomy. Anesth Analg. 2001 Nov;93(5):1272-6. doi: 10.1097/00000539-200111000-00048. PMID 11682413
- BACKGROUNDAyoub C, Girard F, Boudreault D, Chouinard P, Ruel M, Moumdjian R. A comparison between scalp nerve block and morphine for transitional analgesia after remifentanil-based anesthesia in neurosurgery. Anesth Analg. 2006 Nov;103(5):1237-40. doi: 10.1213/01.ane.0000244319.51957.9f. PMID 17056961