Background and Aims: A previous meta‑analysis reported that scalp block had limited
benefits (low‑quality evidence) compared to no‑scalp block modalities for analgesia after craniotomy.
However, it included studies using two different pain intensity measurement scales. Therefore, we
performed another meta‑analysis using a single scale. Methods: We conducted the search for all
randomised controlled trials evaluating the effect of scalp block on postcraniotomy pain compared
to no‑scalp block in Cochrane Central Register of Controlled Trials and PubMed database. We
assessed the quality of included studies employing GRADE approach. We performed random‑effects
inverse‑variance weighted meta‑analysis of outcomes including pain intensity assessed by a 0‑‑10
visual analog scale and opioid consumption during the first 24 h postoperative period using RevMan
5.3. Results: A total of 10 studies (551 patients) were included. It revealed a statistically significant
mean pain intensity reduction in scalp block group when compared to no‑scalp block at very early
and early 24 h period (seven trials, very low‑quality evidence, mean difference (MD) = −1.37, 95%
confidence interval (CI): −2.23 to ‑0.05, I2 = 70%; nine trials, very low‑quality evidence, MD = −1.16,
95% CI: −2.09 to −0.24, I2 = 57%, respectively). There was also reduction in the opioid requirements
over the first 24 h postoperatively. Conclusion: Scalp block might be useful at <6 h postcraniotomy
with very‑low quality evidence. Additionally, it had uncertain but moderate effect on reducing total
24 h opioid consumption. Therefore, more studies are needed to reach optimal information size
