Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

Syrous, Nesjla Sofia; Sundstrøm, Terje; Søfteland, Eirik; Jammer, Ib

doi:10.3390/brainsci11121636

“…Preoperative bodily pain may more strongly contribute to postoperative chronic pain than preoperative mental health; however, there was a weak relationship between bodily pain and mental health (Spearman's correlation coe cient was 0.37, p < 0.001). Some drugs, including dexmedetomidine and acetaminophen, decrease post-craniotomy pain (20,21), which was inconsistent with our results. This could be attributed to our small sample size.…”

Section: Resultscontrasting

confidence: 99%

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Phoowanakulchai

¹

,

Ida

²

,

Naito

³

et al. 2023

Preprint

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Background There have been few reports on persistent incisional pain at 1 year after craniotomy. Hence, this study aimed to explore the distribution of pain at 1 year after elective craniotomy and its related factors. Methods This retrospective study included data prospectively collected to assess postoperative functional disability. We included patients aged > 55 years at the time of recruitment for our initial study and who had complete data regarding the pain numeric rating scale (NRS) score at 1 year post craniotomy. The primary outcome was the pain NRS score, which was assessed at the postanesthetic clinic as well as at 3 months and 1 year after craniotomy. Multivariable negative binomial regression analysis was performed to analyze the relationship between the pain NRS score at 1 postoperative year and 12 clinically meaningful covariates. These included the Short Form-8 scores for bodily pain and mental health, with higher scores indicating better health. Results We analyzed data from 102 patients. The mean (95% confidence interval) pain NRS scores at the three measurement points were 2.8 (2.3–3.3), 1.2 (0.8–1.6), and 0.6 (0.3–0.8), respectively. Multivariable analysis revealed that preoperative bodily pain (risk ratio, 0.93; 95% confidence interval, 0.88–0.98) and the pain NRS score at the postanesthetic clinic (risk ratio, 1.32; 95% confidence interval, 1.14–1.52) were associated with the risk of persistent pain at 1 postoperative year. Conclusions The pain score at 1 year after elective craniotomy was minor; however, preoperative bodily pain and postoperative pain scores were significantly related factors.

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“…Some drugs, including dexmedetomidine and acetaminophen, decrease post-craniotomy pain [ 19 , 20 ], which was inconsistent with our results. This could be attributed to our small sample size.…”

Section: Discussioncontrasting

confidence: 97%

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Phoowanakulchai

¹

,

Ida

²

,

Naito

³

et al. 2023

BMC Anesthesiol

1

0

View full text Add to dashboard Cite

Background There have been few reports on persistent incisional pain at 1 year after craniotomy. Hence, this study aimed to explore the distribution of pain at 1 year after elective craniotomy and its related factors. Methods This retrospective study included data prospectively collected to assess postoperative functional disability. We included patients aged > 55 years at the time of recruitment for our initial study and who had complete data regarding the pain numeric rating scale (NRS) score at 1 year post craniotomy. The primary outcome was the pain NRS score, which was assessed at the postanesthetic clinic as well as at 3 months and 1 year after craniotomy. Multivariable negative binomial regression analysis was performed to analyze the relationship between the pain NRS score at 1 postoperative year and 12 clinically meaningful covariates. These included the Short Form-8 scores for bodily pain and mental health, with higher scores indicating better health. Results We analyzed data from 102 patients. The mean (95% confidence interval) pain NRS scores at the three measurement points were 2.8 (2.3–3.3), 1.2 (0.8–1.6), and 0.6 (0.3–0.8), respectively. Multivariable analysis revealed that preoperative bodily pain (risk ratio, 0.93; 95% confidence interval, 0.88–0.98) and the pain NRS score at the postanesthetic clinic (risk ratio, 1.32; 95% confidence interval, 1.14–1.52) were associated with the risk of persistent pain at 1 postoperative year. Conclusions The pain score at 1 year after elective craniotomy was minor; however, preoperative bodily pain and postoperative pain scores were significantly related factors.

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“…Although we included only a small number of patients in our study, data analysis shows that a single dose of dexamethasone given at the time of induction reduces PONV after LC, which is comparable to other studies done in the past. It is not an expensive drug, and according to our results and other previous studies, it can be used regularly at the time of induction in LC, and it has been found more effective in preventing PONV than other anti-emetic drugs available (Neufeld, 2009;Shaheed, 2017;Syrous et al, 2021).…”

Section: Resultssupporting

confidence: 64%

Iincidence of Post-Operative Nausea and Vomiting in Laparoscopic Cholecystectomy With a Single Dose of Preoperative Dexamethasone

NAEEMI

2023

Biol Clin Sci Res J

0

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and vomiting (PONV). Dexamethasone, a synthetic glucocorticoid with potent anti-inflammatory, immune-modulating, analgesic, and anti-emetic effects, effectively reduces the incidence of PONV after laparoscopic cholecystectomy. In this double-blind, placebo-controlled study, we aimed to investigate the efficacy of a single 8 mg dose of dexamethasone in preventing PONV in patients undergoing laparoscopic cholecystectomy. Sixty patients were randomized into two groups: group A, who received an 8 mg dexamethasone injection in a 2-ml preparation, and group B, who received normal saline during induction. Both groups received standardized anesthesia. Post-operatively, the incidence of nausea and vomiting was observed in both groups. Our study's findings indicate that no substantial variances were observed between the two cohorts in terms of medical or demographic factors. However, a lower proportion of patients in group A exhibited post-operative nausea and vomiting (PONV), while group B had a higher demand for anti-emetic medications to alleviate PONV symptoms. Thus, we can infer that administering a solitary dose of dexamethasone before laparoscopic cholecystectomy can reduce the risk of post-operative complications in patients.

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Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

Cited by 12 publications

References 39 publications

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Iincidence of Post-Operative Nausea and Vomiting in Laparoscopic Cholecystectomy With a Single Dose of Preoperative Dexamethasone

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