Scalp blocks for brain tumor craniotomies: A retrospective survival analysis of a propensity match cohort of patients. (May 2018)

• Record Type: Journal Article
• Authors: Cata, Juan P.; Bhavsar, Shreyas; Hagan, Katherine B.; Arunkumar, Radha; Shi, Ted; Grasu, Roxana; Dang, Anh; Carlson, Richard; Arnold, Benjamin; Popat, Keyuri; Potylchansky, Yuri; Lipski, Ian; Raty, Sally; Nguyen, Anh T.; McHugh, Thomas M.; Feng, Lei; Rahlfs, Thomas F.
• Is Part Of: Journal of clinical neuroscience. Volume 51(2018)
• Page Start: 46
• Page End: 51
• Publication Date: 2018-05
• Subjects: Glioma -- Anesthesia -- Recurrence -- Scalp block; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.02.022
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: The use of scalp block is associated with opioid-sparing effects. The use of scalp block is not associated with longer progression-free survival. The use of scalp block is not associated with longer overall survival. Abstract: To test the association between the use of scalp blocks for malignant brain tumor craniotomy and survival. This is a retrospective study conducted in a tertiary academic center. Demographic, intraoperative and survival data from 808 adult patients with malignant brain tumors was included in the analysis. Patients were divided in those who received an Intraoperative use of scalp block or not. The progression free survival (PFS) and overall survival (OS) rates were compared in patients who had and had not scalp blocks. Kaplan-Meier method was used for time-to-event analysis including recurrence free survival and overall survival. Multivariate analyses before and after propensity score matching were conducted to test the association between different covariates including scalp blocks with PFS and OS. Five hundred and ninety (73%) of the patients had a scalp block. Before PSM, patients with a scalp block were more likely to have an ASA physical status of 3–4, recurrent tumors and receive adjuvant radiation. Patients with scalp block showed no significant reduction in intraoperative opioids. After adjusting for significant covariates, the administration of a scalp block was not associated with an increase in PFS (HR, 95%CI = 0.98, 0.8–1.2, p = 0.892) or OS (HR, 95%CI = 1.02, 0.82–1.26, p = 0.847) survival. This retrospective study suggests that the use of scalp blocks during brain tumor surgery is not associated with patients' longer survival.