Scalp Infiltration With Methylprednisolone Plus Ropivacaine for Post-Craniotomy Pain in Children
Status:
Not yet recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
At present, pediatric postoperative analgesia has not been fully understood and controlled,
particularly craniotomy surgery. On the one hand, professional evaluation of postoperative
pain for young children is difficult; on the other hand, the particularity of craniotomy adds
(such as consciousness obstacle, sleepiness, et al) disturbance to the pain assessment in
children. Although opioids administration is regarded as the first-line analgesic for
post-craniotomy pain management, it may be associated with delayed awakening, respiratory
depression, hypercarbia and it may interfere with the neurologic examination. For the
avoidance of side-effects of systemic opioids, local anesthetics administered around the
incision have been performed clinically. However, some studies revealed that the analgesic
effect of local anesthetics was unsatisfactory due to its short pain relief duration, steroid
as adjuvant can enhance postoperative analgesia and prolong postoperative analgesia time. As
is reported that postoperative pain of craniotomy is mainly caused by skin incision and
reflection of muscles, preventing the liberation of inflammatory mediators around the
incision seems to be more effective than simply blocking nerve conduction. Thus,
investigators suppose that pre-emptive scalp infiltration with steroid (Methylprednisolone)
plus local anesthetic (ropivacaine) could relieve postoperative pain after craniotomy in
children.