Scalp Blocks

CA-2 · II.B.1.a

44Sources
6Kept
1Dropped

1 · Find evidence

PubMed query

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44 candidate papers · 8 excluded

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Same-day build

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PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

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7 points

This meta-analysis found that adding dexmedetomidine to local anaesthetic for scalp nerve blocks in craniotomy patients reduced heart rate by 8.1 bpm and mean arterial pressure by 8.5 mmHg at pin fixation, and prolonged time to first rescue analgesia by 215 minutes. PMID 41138510 kept
This randomized trial found that adding dexmedetomidine 1 mcg/kg instead of dexamethasone 8 mg to 0.5% ropivacaine for scalp nerve blocks in awake craniotomy prolongs time to first rescue analgesia to 14 hours and better attenuates the hemodynamic response to skull pin fixation. PMID 41197576 kept
This review recommends minimizing opioids to facilitate prompt postoperative neurosurgical assessment and found that scalp nerve blocks lower pain and opioid consumption for the first 48 hours while significantly decreasing postoperative nausea and vomiting. PMID 38472617 kept
This review identifies scalp block as an intraoperative nonopioid analgesic strategy in neurosurgery and suggests multimodal analgesia may be most effective, with scalp block used alongside local anesthetic infiltration with bupivacaine, ropivacaine, or lidocaine. PMID 35718395 — not confirmed against the abstract: Abstract does not state scalp block is used alongside local anesthetic infiltration. dropped
This PROSPECT systematic review recommends that the analgesic regimen for craniotomy should include a regional analgesic technique, specifically either incision-site infiltration or a scalp nerve block, with opioids reserved as rescue analgesics. PMID 37417808 kept
This randomized trial found that a multimodal protocol including a postoperative bupivacaine scalp block, gabapentin, dexmedetomidine, acetaminophen, and ketorolac significantly reduced VAS pain scores at 1, 2, and 4 hours after elective supratentorial craniotomy compared to IV morphine. PMID 40883667 kept
This review identifies scalp block as an intraoperative nonopioid analgesic strategy for neurosurgery, noting that multimodal analgesia incorporating these blocks may be most effective. PMID 35718395 kept

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