A Randomized controlled study to assess the efficacy of ropivacaine instillation through subgaleal drain for postcraniotomy pain

Title of this study isA randomized controlled study to assess the efficacy         of ropivacaine instillation through subgaleal drain for postcraniotomy pain.

Majority of patients experiences moderate-to-severe pain after craniotomy.Wound instillation of local anaesthetic drugs as a modality for postoperative pain management     has proved quite useful in surgeries such as spine surgeries, laparoscopy, mastectomy, hysterectomy and caesarean section. Various local anaesthetic (LA) drugs such as bupivacaine, levobupivacaine and ropivacaine have been studied for this technique. Ropivacaine is long- acting and exhibits differential blockade predominantly on sensory nerve fibres. It has been successfully and safely used in neurosurgical patients for local infiltration at pin sites, incision site and scalp block. Ropivacaine has better safety profile among all these drugs and had been studied its instillation via subgaleal drains in 0.25% concentration. As there is no study comparing the effect of low concentration of ropivacaine instillation through subgaleal drain so we planned to study the efficacy of low concentrations of ropivacaine such as 0.1% and 0.2% through subgaleal drain for postcraniotomy pain.

Aim of this study is to assess the efficacy of ropivacaine instillation  through subgaleal drain for post craniotomy pain in patients undergoing elective craniotomy.

Objectiveis to assess postoperative pain by NRS (Numeric Rating Scale) and to compare the duration of analgesia.

In this study we will instill the 12ml of 0.1 % and 0.2% ropivacaine through subgaleal drain in post craniotomy patients at the time of dural closure. The patient will be divided into three groups consists of group A (NS), group B (0.1% Ropivacaine), group C ( 0.2% ropivacaine) Then we will assess  the patients for post craniotomy pain through NRS scale, patient satisfaction score.

Outcome measures of this study will assess the post operative pain in patients undergoing elective craniotomy by NRS scale,patient satisfaction score, hemodynamic parameters such as HR, SBP, DBP, MAP,SPO2, RR, Preoperative and postoperative GCS.