关键词: 外周神经阻滞, 头部神经阻滞, 颅骨切开术, 曲马多

Abstract: Objective To observe the effects of scalp nerve block combined with tramadol PCA on the postoperative pain undergoing craniotomy. Methods 60 adult patients(ASA physical status Ⅰ or Ⅱ) scheduled for frontotemporal craniotomies were randomly assigned into three groups: ropivacaine group (scalp nerve block with 10 mL of ropivacaine 1%), long-lasting lidocaine group (scalp nerve block with 10 mL of long-lasting lidocaine 0.8%) and saline group (scalp block with 10 mL of saline 0.9%). After the induction of general anesthesia, the scalp nerve block including the supraorbital nerve, the auriculotemporal nerves, and the greater, lesser occipital nerves was performed. The anesthesiologists performing the block were blinded to the drug being administered. Anesthesia was standarded. Patient-controlled analgesia (PCA) was used for the postoperative analgesia with tramadol. VAS scores were measured at 2 h, 24 h, 48 h after craniotomy. Results Average visual analog scale scores(VAS) within 2 h postoperative of saline, long-lasting lidocaine and ropivacaine group were (42.0±19.7)mm, (25.2±16.4)mm, (38.6±24.5)mm respectively . VAS were higher in the Saline group as compared with long-lasting lidocaine group(P<0.05) . VAS scores at 24 h and 48 h decreased as compared with VAS scores at 2 h, especially in the Saline group. Conclusion Scalp nerve block combined with tramadol PCA can successfully reduces postoperative pain after craniotomy.

Key words: peripheric nerve block, scalp nerve block, craniotomy, tramadol