Adding Dexamethasone to Lidocaine in Scalp Incision Infiltration for Craniotomy

Effect of Adding Dexamethasone to Lidocaine in Scalp Incision Infiltration for Craniotomy

This study aimed to test the hypothesis that pre-emptive scalp infiltration with a steroid (dexamethasone) plus a local anesthetic (xylocaine) could achieve superior postoperative analgesic effects to a local anesthetic (xylocaine) plus epinephrine in adult patients undergoing a craniotomy.

Approximately 55-87% of patients undergoing craniotomy experience moderate to severe pain during the first 48 hours after surgery, which negatively influences their postoperative rehabilitation.

Recently, local infiltration of analgesia (LIA) has been widely performed clinically as a promising analgesic method that could avoid the side effects of analgesics but only has a short pain-free duration; researchers have clarified that the addition of dexamethasone to LIA could provide significant analgesic effects and significantly prolong the duration of analgesic effects without obvious complications for various types of surgeries.

To date, no studies have evaluated the addition of dexamethasone to LIA for patients receiving craniotomy.

Inclusion Criteria:

• Patients age between 20 and 60 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I and II
• Scheduled for elective supratentorial tumor craniotomy under general anesthesia.

Exclusion Criteria:

• Patients with known hypersensitivity to lidocaine or dexamethasone.
• Chronic corticosteroid therapy.
• Pre-existing coagulopathy.
• Significant hepatic or renal impairment.