Ketamine Versus Dexmedetomidine as an Adjuvant in Scalp Block in Supratentorial Brain Tumor Excision Surgeries

Inclusion Criteria: * Age from 20 to 60 years, both sexes, American Society of Anesthesiologists (ASA) physical status II-III, Supratentorial tumor excision, Supine Position. and operation time: less than 6 hours. Exclusion Criteria: * Patient refusal, disturbed consciousness level (Glasgow Coma Scale \[GCS\] \< 15). Patients who required reintubation during the study period, those not extubated. immediately after surgery, or those who awoke with neurological deficits impairing. pain assessments were excluded from the final analysis, history of psychotic disorders or previous surgeries, Poor cognitive function. Postictal state or uncontrolled/recurrent seizures, known allergy to dexmedetomidine or ketamine, difficult intubation (Mallampati score \> III) or multiple intubation attempts, operation duration \> 6 hours, renal dysfunction (creatinine \> 1.2 mg/dL, BUN \> 20 mg/dL), heart block and patients with chronic headache disorders or those receiving chronic analgesic therapy (for \>3 months) were excluded.