COMPARISON OF SCALP INFILTRATION WITH BUPIVACAINE AND INTRAVENOUS MORPHINE ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING CRANIOTOMY

Post Craniotomy surgery headache is classified as moderate to severe pain.
Objective of this study was comparison of Bupivacaine scalp infiltration and intravenous morphine on
postoperative headache in patients undergoing craniotomy.
Materials & Methods: This study was a double blind clinical trial set up at Mashhad University of
Medical Science. Sample size was 70 patients (block randomization) who underwent elective supra
tentorial craniotomy and patients were divided into two groups of control and case (sub-dermal local
infiltration of Bupivacaine %0.25 in incision area versus parenteral administration of morphine). Then
we measured Visual Analog Scale (VAS) at 0, 2, 4, 6, 8, 12 and 24 hours after intervention.
Results: According to VAS, at beginning of the study, moderate pain was observed more while severe
pain was observed less in the case group (p=0.003); at 2 and 4 hours after intervention most patients
in case group had mild pain versus moderate pain in control group (p=0.00). At 6 and 12 hour after
intervention, mild and moderate pain were significantly more present in Bupivacaine group (p=0.009
and 0.003, respectively).
Conclusion: Sub-dermal local infiltration of Bupivacaine decrease post craniotomy severe headache
in the first 12 hours after surgery