When to Block? Timing of Scalp Block in Craniotomy

This study aims to evaluate the effect of scalp block timing-Group 1 will receive a pre-pinning scalp block, while Group 2 will receive a pre-emergence scalp block.-on postoperative recovery quality in patients undergoing supratentorial tumor craniotomy. The recovery quality will be assessed using the validated Quality of Recovery-40 (QoR-40) questionnaire. A total of 60 patients, aged 18-80 years, classified as ASA I-III and with a Glasgow Coma Scale (GCS) score of 15 upon admission to the recovery unit, will be enrolled. The primary outcome is the QoR-40 score. Secondary outcomes include hemodynamic changes and pain intensity measured by the Visual Analog Scale (VAS).

Inclusion Criteria: * Patients aged between 18 and 80 years. * Scheduled for elective supratentorial tumor craniotomy under general anesthesia * ASA physical status classification I to III. * Glasgow Coma Scale (GCS) score of 15 at the time of emergence from anesthesia. * Provide informed consent to participate in the study. Exclusion Criteria: * Chronic use of analgesic medications prior to surgery. * Glasgow Coma Scale (GCS) score below 15 postoperatively. * Allergy or hypersensitivity to local anesthetics or opioids used in the study. * Contraindications for scalp block or patient-controlled analgesia. * Patients with severe hepatic, renal, or cardiac dysfunction. * Patients unable to comprehend or complete the QoR-40 questionnaire.