Effect of different local anesthetics for incision infiltration after craniotomy under general anesthesia
CAI Bo-tao
TANG Ji-wei
LIAO Sha
LI Yong
Abstract：Objective To investigate the effect of different local anesthetics for incision infiltration after cranioto-my under general anesthesia on patient-controlled intravenous analgesia(PCIA)after craniotomy under general anesthe-sia.Methods Sixty patients undergoing elective temporal lobe epilepsy lesion resection between June 2024 and May 2025 were enrolled and randomly divided into two groups(n=30 each)using a random number table.In the ropivacaine group(L group),patients received 0.5％ropivacaine(100 mg/10 mL ropivacaine hydrochloride injection+10 mL nor-mal saline)for scalp infiltration before incision.In the liposomal bupivacaine group(B group),patients received 0.665％liposomal bupivacaine(133 mg/10 mL liposomal bupivacaine+10 mL normal saline)for scalp infiltration.Postoperative analgesia was managed with a standardized PCIA protocol for 48 h.Pain intensity was assessed using the vis-ual analogue scale(VAS)at 4,12,24,and 48 h postoperatively.Additional endpoints included the number of PCIA pump presses,number of patients requiring rescue analgesics,and incidence of analgesia-related adverse events(nause-a,vomiting,dizziness,somnolence,fever).Results In the early postoperative period(4 h and 12 h),no significant differences in VAS scores were observed between groups(P＞0.05).However,at 24 h and 48 h postoperatively,analge-sia in the B group was significantly superior to that in the L group,with lower VAS scores(P＜0.05).The frequency of PCIA pump presses was markedly reduced in the B group compared with the L group(P＜0.05).The proportion of pa-tients requiring rescue analgesics was significantly lower in the B group(P＜0.05).The overall incidence of postoperative adverse events was also significantly lower in the B group compared with the L group(P＜0.05).Conclusion Liposom-al bupivacaine scalp incision infiltration is a safe and effective method for postoperative analgesia in craniotomy patients.Compared with ropivacaine,it provides superior pain control,reduces the need for additional analgesics,and lowers the incidence of adverse events.
Keywords：liposomal bupivacaineincision infiltrationcraniotomypostoperative analgesia
Publication Date：2025-10-15
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：4( 1474-1477 )