Effects of scalp nerve block on pain and emergence agitation after paediatric nevus surgery: a clinical trial

Kim, J.-S.; Kim, G. W.; Park, D. H.; Ahn, Hyochun; Chang, Min Ying; Kim, J. Y.

doi:10.1111/aas.12942

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…In this study, 0.3 µg/kg of fentanyl was administered during the anesthetic induction. Although fentanyl as an adjuvant was reported to reduce the emergence agitation from sevoflurane anesthesia [18], the incidence of emergence agitation in this study was similar to that of Kim’s study (51% vs. 55%, respectively) [11]. First, fentanyl as a rescue analgesic in the PACU was administered immediately on arrival at the PACU without pre-assessment of the emergence agitation in Kim’s study.…”

Section: Discussionsupporting

confidence: 61%

“…Emergence agitation was found in 50% of children undergoing magnetic resonance imaging under sevoflurane anesthesia without surgery [10]. The elimination of postoperative pain via a scalp nerve block failed to reduce the occurrence of emergence agitation following sevoflurane anesthesia in children undergoing an excision of scalp nevi [11]. Conversely, a meta-analysis found that propofol, alpha2-adrenoceptors, ketamine, fentanyl, and perioperative analgesia induce a prophylactic effect against emergence agitation [12].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Size and Location of Nevi on Postoperative Pain and Emergence Agitation in Children Undergoing Nevi Excision

Lee

Park

Seok

et al. 2019

JCM

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Congenital melanocytic nevi need surgical excisions. However, the effect of the size and location of the nevi on pain and emergence agitation have yet to be studied. The objective of this study was to evaluate (1) the ideal parameter of the nevus size and (2) the effects of the size and location of the nevus on pain and emergence agitation. This observational study enrolled 100 children scheduled for an excision of a nevus under sevoflurane anesthesia. The parameters of the nevus size included the long diameter, the area before resection, the area of resection, and the proportion (the area of resection/total body surface). The nevus locations included the trunk, face, scalp, and extremities. The proportion of the nevi was the most ideal parameter in evaluating the pain and emergence agitation. A large size showed a higher emergence agitation than a small size (median (range); 6 (0–20) in small groups vs. 12.5 (0–20) in large groups, p = 0.021). However, the pain was comparable. The nevus location did not influence pain or emergence agitation. In a multivariate regression analysis, a younger age and an extensive excision were associated with higher pain and emergence agitation. In conclusion, large nevi induced more severe emergence agitation. However, the nevus location did not affect the outcome. In addition, a younger age was associated with pain and emergence agitation. Clinicians need to consider the proportion of nevi when managing children undergoing a nevus excision.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Effect of Size and Location of Nevi on Postoperative Pain and Emergence Agitation in Children Undergoing Nevi Excision

Lee

Park

Seok

et al. 2019

JCM

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“…A second scalp nerve block at the end of surgery can extend the duration of nerve block and provide better postoperative analgesia [ 12 ]. Therefore, the use of scalp nerve block in pediatric craniotomy can reduce intraoperative stress while providing some postoperative analgesia and helping speed up postoperative recovery [ 13 , 14 ]. In addition, a good scalp nerve block can also be used for intraoperative awakening children receiving craniotomy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction

Zou

Ding

et al. 2023

BMC Anesthesiol

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Objective Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone. Methods This was a single-center, prospective, randomized, controlled study. A total of 60 children aged 6-24 months who underwent cranial suture reconstruction were randomly divided into two groups: Group A (general anesthesia combined with scalp nerve block) and Group N (general anesthesia). The hemodynamics were recorded preoperatively, at 5 min after incision and at 1, 6 and 12 h after surgery; the pain was scored at 1, 6 and 12 h after surgery, and blood glucose was detected at 1 h after surgery. Results The mean arterial pressure and heart rate at 5 min after incision and 1 h after surgery in Group N were higher than those in Group A; the blood glucose and FLACC score in Group N were higher than those in Group A; and the number of postoperative analgesic pump presses were also significantly increased in Group N. Conclusion Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.

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“…Six studies were screened out following the full-text reading. Finally, a total of 20 eligible studies were selected for this meta-analysis [18,19,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Eligible Studiesmentioning

confidence: 99%

Effect of regional anesthesia on the postoperative delirium: A systematic review and meta-analysis of randomized controlled trials

Dong

Cui

et al. 2022

Front. Surg.

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ObjectivePostoperative delirium (POD) starts in the recovery room and occurs up to 5 days after surgery. However, the POD guidelines issued by the European Society of Anesthesiology (ESA) suggest that the effect of regional anesthesia on POD is controversial. This meta-analysis aims to investigate whether perioperative regional anesthesia reduced the incidence of POD.MethodsStandard Published randomized controlled trails (RCTs) were searched from bibliographic databases to identify all evidence that reported regional anesthesia assessing incident delirium following diverse surgeries. The primary outcome was the incidence of POD, and the secondary outcomes were POD scores, pain scores, and emergence time. The relative risk (RR) for dichotomous outcomes and the weighted or standardized mean difference (WMD, SMD) for continuous outcomes were estimated using a random-effects model.ResultsTwenty RCTs with 2110 randomized participants undergoing different surgeries were included. Meta-analysis showed that regional anesthesia was associated with less POD incidence compared to general anesthesia (total intravenous anesthesia (TIVA) or inhalation anesthesia) (relative risk (RR) = 0.62, 95% confidence interval (CI) = 0.45–0.85)). Subgroup analysis showed that the decrease in POD incidence was associated with a nerve block (0.46, 95% CI = 0.32–0.67) and regional-combined-general anesthesia (0.42, 95% CI = 0.29–0.60). Regional anesthesia significantly reduced POD incidence in the recovery room after pediatric surgeries (0.41, 95% CI = 0.29–0.56). Regional anesthesia also reduced the POD score (SMD −0.93, 95% CI = −1.55 to −0.31) and pain score (SMD −0.95, 95% CI = −1.72 to −0.81). There was no significant difference in emergence time between regional anesthesia and general anesthesia (WMD −1.40, 95% CI = −3.83 to 6.63).ConclusionsThere was a significant correlation between regional anesthesia and the decrease in POD incidence, POD score, and pain score.

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Effects of scalp nerve block on pain and emergence agitation after paediatric nevus surgery: a clinical trial

Abstract: The scalp nerve block decreased the early post-operative pain after paediatric nevus excision, but it did not decrease the incidence of EA with sevoflurane anaesthesia.

Cited by 6 publications

References 26 publications

Effect of Size and Location of Nevi on Postoperative Pain and Emergence Agitation in Children Undergoing Nevi Excision

Effect of Size and Location of Nevi on Postoperative Pain and Emergence Agitation in Children Undergoing Nevi Excision

Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction

Effect of regional anesthesia on the postoperative delirium: A systematic review and meta-analysis of randomized controlled trials

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