Nerve Block Anesthesia Combined With Sedative Anesthesia Versus General Anesthesia in Surgery for CSDH
Safety of Nerve Block Anesthesia Combined With Sedative Anesthesia Versus General Anesthesia in Burr Hole Craniostomy With Drainage for Chronic Subdural Hematoma
Beijing Tiantan Hospital
190 participants
Apr 1, 2024
INTERVENTIONAL
Conditions
Summary
A prospective, multicenter, randomized controlled trial is designed to evaluate the safety of nerve block anesthesia combined with sedative anesthesia versus general anesthesia during burr hole craniostomy with drainage for chronic subdural hematoma.
Eligibility
Inclusion Criteria4
- Patients with chronic subdural hematoma with preoperative neurological dysfunction for burr hole drainage;
- Age beween 18 to 80
- Chronic subdural hematoma verified on cranial computed tomography or magnetic resonance imaging with hematoma thickness >1.0cm or midline shift >1.0 cm.
- Written informed consent obtained
Exclusion Criteria8
- Preoperative unconsciousness (Glasgow Coma Scale<13, or Markwalder Grade 2-4) or cognitive dysfunction (Mini-Cog≤3, or MMSE≤20)
- Preoperative sensory or motor aphasia
- Recurrence of hematoma with previous surgery for chronic subdural hematoma.
- Previous intracranial surgery or with intracranial lesion
- with severe comorbidity or other organ dysfunction
- Allergic to anesthetics
- Severe coagulopathy or high risk of life-threatening bleeding
- Participating in another research
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Interventions
Patients in the nerve block anesthesia combined with sedative anesthesia group will first receive cranial nerve blocks under standard monitoring. At the same time, intravenous dexmedetomidine infusion is started for sedation at a rate of 2-4ug/kg for 10 minutes, followed by a continuous infusion of 0.5-1ug/kg/h until the Richmond Agitation-Sedation Scale (RASS) of -3.
Patients will be induced with propofol or etomidate, sufentanil , rocuronium or cisatracurium .
Locations(1)
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NCT05888389