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Background and aim <p>Awake craniotomy and deep brain stimulation (DBS) procedures require the patient to be awake and adequate anesthesia conditions are typically achieved using a&#xa0;scalp block. These procedures inherently involve some degree of pain from local anesthetic injections during scalp block administration. We aimed to reduce the injection pain in scalp blocks using a&#xa0;vibration stimulus.</p> Methods <p>A&#xa0;total of 56&#xa0;patients aged between 18&#xa0;and 75&#xa0;years undergoing awake craniotomy and DBS procedures were enrolled in the study. All patients received a&#xa0;loading dose of dexmedetomidine before scalp block administration. Local anesthetic injections were applied sequentially to the identically named nerves on the right and left sides of the head. A&#xa0;vibration device was used during injections on one side, while injections on the other side were performed without vibration. The numeric rating scale (NRS) score and hemodynamic measurements during each injection, including heart rate and mean arterial pressure were compared between vibration and nonvibration sides.</p> Results <p>The NRS scores were lower on the side where vibration was used during scalp block injections (<i>P</i> &lt; 0.001). Additionally, there was a&#xa0;decrease in heart rate and mean arterial pressure on the side where vibration was used compared to the baseline value (<i>P</i> &lt; 0.005).</p> Conclusion <p>The study showed that using topical vibration during a&#xa0;scalp block can decrease the pain of a&#xa0;local anesthetic injection and maintain hemodynamic stability.</p> Trial registration <p>ClinicalTrials.gov (NCT06038825).</p> Graphic abstract <p></p>

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Effect of topical vibration on pain during scalp block injections in awake craniotomy and deep brain stimulation surgery

  • 期刊论文

  • 发表日期：

    2025年11月7日

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  • Nur Yilmaz,
  • Ceyda Ozhan Caparlar,
  • Aylin Kilincarslan,
  • Fatma Ozkan Sipahioglu,
  • Derya Ozkan,
  • Caner Unluer

摘要

Background and aim

Awake craniotomy and deep brain stimulation (DBS) procedures require the patient to be awake and adequate anesthesia conditions are typically achieved using a scalp block. These procedures inherently involve some degree of pain from local anesthetic injections during scalp block administration. We aimed to reduce the injection pain in scalp blocks using a vibration stimulus.

Methods

A total of 56 patients aged between 18 and 75 years undergoing awake craniotomy and DBS procedures were enrolled in the study. All patients received a loading dose of dexmedetomidine before scalp block administration. Local anesthetic injections were applied sequentially to the identically named nerves on the right and left sides of the head. A vibration device was used during injections on one side, while injections on the other side were performed without vibration. The numeric rating scale (NRS) score and hemodynamic measurements during each injection, including heart rate and mean arterial pressure were compared between vibration and nonvibration sides.

Results

The NRS scores were lower on the side where vibration was used during scalp block injections (P < 0.001). Additionally, there was a decrease in heart rate and mean arterial pressure on the side where vibration was used compared to the baseline value (P < 0.005).

Conclusion

The study showed that using topical vibration during a scalp block can decrease the pain of a local anesthetic injection and maintain hemodynamic stability.

Trial registration

ClinicalTrials.gov (NCT06038825).

Graphic abstract