It's really only effective against targets who aren't resisting. You could always ask them to hold still and stop struggling. It won't work, but you'll feel better that you tried. - Ingame weapon description.
The scalpel is a weapon that appears in MADNESS: Project Nexus. It is a tier 3 weapon, meaning it is unlocked after completing the 3rd arena.
Strategy
The scalpel on its own is extremely ineffective as a melee weapon due to low damage and durability, breaking in only a few swings. This weapon swings much faster than other weapons due to its size, which only serves in breaking it quicker. However, the scalpel can be used to instantly execute a single enemy without the need to dizzy them, provided the wielder has the improvised execution skill.