The goal of this randomized controlled clinical trial is to compare the effectiveness of systemic opioids versus pre-incision bilateral scalp nerve block in managing intraoperative noxious stimuli and postoperative pain in adult patients (18-75 years) undergoing elective supratentorial craniotomy. The main questions this study aims to answer are: Does pre-incision bilateral scalp nerve block provide better intraoperative hemodynamic stability compared to systemic opioids? Does it result in lower postoperative pain scores and reduced opioid consumption during the first 24 hours after surgery? Researchers will compare Group M (systemic morphine) with Group S (bilateral scalp nerve block) to see if the scalp nerve block offers superior analgesia and fewer opioid-related side effects. Participants will: Be randomly assigned to receive either systemic morphine or bilateral scalp nerve block before incision. Undergo standard general anesthesia for craniotomy. Have postoperative pain managed using a patient-controlled analgesia (PCA) morphine pump and be monitored for 24 hours for pain, sedation, and nausea/vomiting scores
Age range
18 Years – 75 Years
Sex
ALL
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Intraoperative Heart Rate Response to Noxious Stimuli
Timeframe: Intraoperative Period- from induction of anesthesia until skin closure.
Intraoperative Systolic Blood Pressure Response to Noxious Stimuli
Timeframe: Intraoperative Period- from induction of anesthesia until skin closure.
Intraoperative Diastolic Blood Pressure Response to Noxious Stimuli
Timeframe: Intraoperative Period- from induction of anesthesia until skin closure.
Intraoperative Mean Arterial Pressure Response to Noxious Stimuli
Timeframe: Intraoperative Period- from induction of anesthesia until skin closure.