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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2018; 05(02): 111-113
DOI: 10.1055/s-0038-1665545
Case Report
Indian Society of Neuroanaesthesiology and Critical Care

Unilateral Complete Ptosis after Scalp Block for Awake Craniotomy: A Rare Complication

Mohamad Hasyizan Hassan
1   Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
,
Wan Mohd Nazaruddin Wan Hassan
1   Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
,
Regunath Kandasamy
2   Department of Neuroscience, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
,
Soon Eu Chong
3   Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
› Author Affiliations Funding None.
Further Information

Publication History

Received: 25 February 2018

Accepted: 28 May 2018

Publication Date:
23 June 2018 (online)

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Abstract

A combination of scalp block and monitored anesthesia care (MAC) is one of the options among anesthetic techniques that can be used during an awake craniotomy for epilepsy surgery. Even though a scalp block is useful as locoregional analgesia during the surgery, it also has the potential to cause some complications. Trigeminocardiac reflex and transient facial nerve palsies have previously been reported following scalp block. The toxicity of local anesthetic agents and nerve injuries present other potential complications. However, complete unilateral ptosis is a rare complication after scalp block. We report a case of unilateral complete mechanical ptosis after a scalp block using ropivacaine 0.75% for an awake craniotomy for epilepsy surgery.

Keywords

awake craniotomy - scalp block - ptosis - ropivacaine
 

  • References

  • 1 Burnand C, Sebastian J. Anaesthesia for awake craniotomy. Contin Educ Anaesth Crit Care Pain 2013; 14 (01) 6-11
    PubMedGoogle Scholar
  • 2 Costello TG, Cormack JR, Mather LE, LaFerlita B, Murphy MA, Harris K. Plasma levobupivacaine concentrations following scalp block in patients undergoing awake craniotomy. Br J Anaesth 2005; 94 (06) 848-851
    CrossrefPubMedGoogle Scholar
  • 3 Guilfoyle MR, Helmy A, Duane D. Hutchinson PJ. Regional scalp block for postcraniotomy analgesia: a systematic review and meta-analysis. Anesth Analg 2013; 116 (05) 1093-1102
    CrossrefPubMedGoogle Scholar
  • 4 Bonhomme V, Franssen C, Hans P. Awake craniotomy. Eur J Anaesthesiol 2009; 26 (11) 906-912
    CrossrefPubMedGoogle Scholar
  • 5 Prabhu VC, Bamber NI, Shea JF, Jellish WS. Avoidance and management of trigeminocardiac reflex complicating awake-craniotomy. Clin Neurol Neurosurg 2008; 110 (10) 1064-1067
    CrossrefPubMedGoogle Scholar
  • 6 Chowdhury T, Baron K, Cappellani RB. Severe bradycardia during scalp nerve block in patient undergoing awake craniotomy. Saudi J Anaesth 2013; 7 (03) 356-357
    CrossrefPubMedGoogle Scholar
  • 7 McNicholas E, Bilotta F, Titi L, Chandler J, Rosa G, Koht A. Transient facial nerve palsy after auriculotemporal nerve block in awake craniotomy patients. A A Case Rep 2014; 2 (04) 40-43
    PubMedGoogle Scholar
  • 8 Pinosky ML, Fishman RL, Reeves ST. et al. The effect of bupivacaine skull block on the hemodynamic response to craniotomy. Anesth Analg 1996; 83 (06) 1256-1261
    CrossrefPubMedGoogle Scholar
  • 9 Costello TG, Cormack JR. Anaesthesia for awake craniotomy: a modern approach. J Clin Neurosci 2004; 11 (01) 16-19
    CrossrefPubMedGoogle Scholar