Efficacy of ultrasound-guided versus body surface localization on scalp nerve block in awake craniotomy: report of 82 cases

Mengning WAN; Yupei CHEN; Youliang DENG; Zedan TIAN; Sheng JING; Yuanhang CHEN

doi:10.16016/j.2097-0927.202209191

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Efficacy of ultrasound-guided versus body surface localization on scalp nerve block in awake craniotomy: report of 82 cases

Clinical Medicine | 更新时间：2026-01-09

- Efficacy of ultrasound-guided versus body surface localization on scalp nerve block in awake craniotomy: report of 82 cases
- Journal of Army Medical University Vol. 45, Issue 6, Pages: 547-553(2023)
- 作者机构：
  
  1.400010 重庆, 重庆医科大学附属第一医院麻醉科
  2.400010 重庆, 重庆医科大学附属第二医院麻醉科
  3.400037 重庆, 陆军军医大学(第三军医大学)第二附属医院麻醉科
- 作者简介：
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(81172122)
- DOI：10.16016/j.2097-0927.202209191
  CLC： R181.32;R614.4;R651.11
- Received：21 September 2022，
  
  Revised：2022-10-12，
  
  Published：30 March 2023
- 稿件说明：
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Mengning WAN, Yupei CHEN, Youliang DENG, et al. Efficacy of ultrasound-guided versus body surface localization on scalp nerve block in awake craniotomy: report of 82 cases[J]. Journal of Army Medical University, 2023, 45(6): 547-553.
DOI：

Mengning WAN, Yupei CHEN, Youliang DENG, et al. Efficacy of ultrasound-guided versus body surface localization on scalp nerve block in awake craniotomy: report of 82 cases[J]. Journal of Army Medical University, 2023, 45(6): 547-553. DOI： 10.16016/j.2097-0927.202209191.

摘要

目的

对比术中唤醒开颅手术(awake craniotomy

AC)中应用超声引导下头皮神经阻滞(ultrasound-guided scalp nerve block

US-guided SNB)与体表定位头皮神经阻滞(scalp nerve block

SNB)的效果差异。

方法

采用回顾性队列研究，分析2016年1月至2022年1月就诊于重庆医科大学附属第一医院及陆军军医大学第二附属医院神经外科的82例脑功能区病变患者的病历资料。其中接受US-guided SNB的纳入观察组(

=39)，患者年龄(50.51±16.49)岁，男19例，体质指数(22.10±3.66)kg/m

。接受体表定位SNB的纳入对照组(

=43)，患者年龄(48.02±16.44)岁，男24例，体质指数(22.98±3.55) kg/m

。比较两组患者的一般资料、手术相关指标及术后并发症情况。记录入室时(T0)、切皮完成时(T1)、唤醒时(T2)、唤醒后10 min(T3)、唤醒后20 min(T4)的平均动脉压(mean arterial pressure

MAP)和心率(heart rate

HR)。

结果

观察组的术中唤醒时间(6.53±1.84) min、唤醒期体动次数(4.92±2.61) 次/h、盐酸尼卡地平(0.97±0.27) mg、瑞芬太尼(1.08±0.35) mg、盐酸右美拖咪定(1.30±0.33) mg以及枸橼酸舒芬太尼(22.42±2.63) ug的用量显著低于对照组，差异均有统计学意义(均

0.05)。两组的HR在T1-T4均呈逐渐上升趋势，其中对照组HR上升更明显，组间比较差异有统计学意义(

=35.978

0.001)。观察组MAP在T1-T2逐渐上升，在T3-T4呈下降趋势，对照组T1-T3呈上升趋势，T4期有所回降，且明显高于观察组，组间比较差异有统计学意义(

=43.286

0.001)。

结论

US-guided SNB技术具有提升AC手术唤醒期手术质量、减少术中全身麻醉药用量、稳定血流动力学的作用。

Abstract

Objective

To compare the efficacy of ultrasound-guided scalp nerve block (US-guided SNB) with that of body surface localization SNB in awake craniotomy (AC).

Methods

A retrospective cohort study was conducted to analyze the medical records of 82 patients with brain lesions who were treated in the Department of Neurosurgery

the First Affiliated Hospital of Chongqing Medical University and the Second Affiliated Hospital of Army Medical University from January 2016 to January 2022. The patients receiving US-guided SNB were included in the observation group (

=39

19 males

averagely aged 50.51±16.49 years

body mass index of 22.10±3.66 kg/m

)

and those receiving body surface localization SNB were enrolled in the control group (

=43

24 males

averagely aged 48.02±16.44 years

body mass index of 22.98±3.55 kg/m

). The general information

operation-related indicators

and postoperative complications were compared between the 2 groups. Mean arterial pressure (MAP) and heart rate (HR) were recorded and analyzed at the time of admission (T0)

skin incision (T1)

awakening (T2)

and 10 min (T3) and 20 min (T4) after awakening.

Results

In the observation group

the intraoperative wake-up time (6.53±1.84 min)

number of body movements during the awake period (4.92±2.61 times/h)

as well as dosages of nicardipine hydrochloride (0.97±0.27 mg)

remifentanil (1.08±0.35 mg)

dexmedetomidine hydrochloride (1.30±0.33 mg)

and sufentanil citrate (22.42±2.63 ug) were significantly lower than those in the control group

with statistical significances (all

0.05). The HR of both groups showed a gradual upward trend at T1~T4

and the increase in the control group was much obvious with significance (

=35.978

0.001). The MAP of the observation group was elevated at T1~T2 and then declined at T3~T4

while the MAP in the control group was increased during T1~T3 and decreased at T4

greatly higher than that in the observation group (

=43.286

0.001).

Conclusion

US-guided SNB technique can improve the quality of AC surgery during awake period

reduce the intraoperative dose of general anesthetics

and stabilize hemodynamics.

关键词

Keywords

references

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