Evaluation of the Efficacy of Neuronavigation-guided Scalp Block for Analgesia in Endoscopic Pituitary Surgery

Abstract

Objective: Scalp block is used to manage pain caused by the skull pin during pituitary surgery. The neuronavigation device allows access to preoperative imaging in the perioperative period. The aim of this study was to determine the efficacy and feasibility of neuronavigation-guided scalp blocks. Method: After ethics committee approval (decision no: 2023-130), patients over 18 years of age who underwent endoscopic pituitary adenoma surgery with scalp block were retrospectively reviewed. After the exclusion criteria, the patients who underwent scalp block were divided into two groups as neuronavigation or anatomical point-guided scalp block (neuronavigation and classic group). The groups were compared with respect to demographic and haemodynamic data, perioperative analgesic consumption, postoperative visual analogue scale (VAS) scores, and complications. Results: The groups were similar in terms of demographics, haemodynamics, operative times, perioperative opioid use, postoperative VAS scores and analgesic use. Perioperative antihypertensive and postoperative rescue analgesic requirements were statistically similar in the neuronavigation and classics groups [1/4 and 6/9 (n/n); p=0.467 and p=0.537, respectively]. Postoperative rescue analgesic consumption at 24 hours was 87.50±30.62 mg in the neuronavigation group and 100.00±37.5 mg in the classic group (p=0.510). No patient had complications at any time. Conclusion: In this study, the perioperative and postoperative efficacy was found to be similar for both methods. We believe that the use of neuronavigation in regional anaesthesia practice has the potential to increase efficacy and reduce the rate of adverse effects, and is therefore innovative and will find a place in existing anaesthesia methods.

Keywords

• neuronavigation
• pituitary surgery
• scalp block
• skull pin