General Anesthesia Versus Locoregional Anesthesia for Evacuation of Chronic Subdural Hematoma

Caen University Hospital

Status: Unknown

Conditions: Chronic Subdural Hematoma

Treatments: Drug: All General anesthesia; Drug: All Locoregional anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT03666949

NEURANESTH

Details and patient eligibility

About

This study compare general anesthesia versus locoregional anesthesia for evacuation of chronic subdural hematoma. Half of participant will be operated under general anesthesia, while the other half will be operated under locoregional anesthesia.

Full description

General anesthesia is the most common technique for this surgery. The local anesthesia is less common but it allows to obtain the same surgical result. This last technique being more recent little study compared these two techniques in terms of complications and postoperative consequences.

The investigators will randomize patients into two groups (a general anesthesia group and a locoregional anesthesia group).

General anesthesia provides complete immobility and optimal surgical comfort but is a source of multiple complications, especially in a population of polypathological and polymedicated elderly patients (which is the population affected by chronic subdural hematomas).

Locoregional anesthesia requires special technical training, leads to complete analgesia of the surgical procedure but does not involve complete immobility of the patient, however this technique probably leads to less postoperative complications and allows a more early rehabilitation.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• subdural chronic hematoma uni or bilateral
• Obtaining an oral consent
• french speaker
• affilliation to French social security

Exclusion criteria

• Patients agitated or not cooperating, not allowing the realization of a locoregional anesthesia
• Patients with other intracranial lesions
• Patients with underlying neurological pathology with a modified Rankin score greater than 1
• Pregnant or lactating women
• Patients under guardianship / curatorship

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

All General anesthesia

Other group

Description:

Use of a hypnotic("propofol 2.5mg/kg"), morphine("remifentanil1yg/kg") and curare("atracurium0.5mg/kg"), with the support of orotracheal intubation and mechanical ventilation

Treatment:

Drug: All General anesthesia

All Locoregional anesthesia

Other group

Description:

Use of a local anesthetic(" xylocaine 1%") for the realization of scalp nerve block

Treatment:

Drug: All Locoregional anesthesia