Integrative review: postcraniotomy pain in the brain tumour patient

Abstract

Aim To conduct an integrative review to examine evidence of pain and associated symptoms in adult (≥ 21 years of age), post-craniotomy, brain tumor patients hospitalized on intensive care units. Background Healthcare providers believe craniotomies are less painful than other surgical procedures. Understanding how post-craniotomy pain unfolds over time will help inform patient care and aid in future research and policy development. Design Systematic literature search to identify relevant literature. Information abstracted using the Theory of Unpleasant Symptoms’ concepts of influencing factors, symptom clusters and patient performance. Inclusion criteria were indexed, peer-reviewed, full-length, English-language articles. Keywords were ‘traumatic brain injury,’ ‘pain, post-operative,’ ‘brain injuries,’ ‘postoperative pain,’ ‘craniotomy,’ ‘decompressive craniectomy,’ and ‘trephining.’ Data sources Medline, OVID, PubMed and CINAHL databases from 2000 – 2014. Review Method Cooper’s five-stage integrative review method was used to assess and synthesize literature. Results The search yielded 115 manuscripts, with 26 meeting inclusion criteria. Most studies were randomized, controlled trials conducted outside of the United States. All tested pharmacological pain interventions. Post-craniotomy brain tumor pain was well-documented and associated with nausea, vomiting and changes in blood pressure and impacted patient length of hospital stay, but there was no consensus for how best to treat such pain. Conclusion The Theory of Unpleasant Symptoms provided structure to the search. Post-craniotomy pain is experienced by patients, but associated symptoms and impact on patient performance remain poorly understood. Further research is needed to improve understanding and management of post-craniotomy pain in this population.

Local anesthetics for brain tumor resection: current perspectives

“…Neurosurgical procedures cause more pain than anesthesiologists expect, 4 and post-craniotomy pain is not always well understood. 5 However, clinicians have become more aware of the incidence and intensity of post-craniotomy pain. There is a large variation in the occurrence of postoperative pain and the requirement of analgesic medication in neurosurgical patients.…”

“… 6 , 7 In a recent review of 26 studies assessing different aspects of postcraniotomy pain, 15 studies reported pain percentages in the first two postoperative days up to 60%–96%. 5 It is unclear why this great variation of the incidence of postoperative pain exists in craniotomy patients. Attributable factors could be the perioperative opioid and analgesic regiment used, the exact moment of the first postoperative pain score and the composition of the neurosurgical population.…”

The nursing experience of caring a patient with metastatic brain tumor in surgical pain management ward: a case study report

“…7 Pain after craniotomy may affect hospital stay, medication costs, quality of life and the development of persistent pain. 8 Although there have been considerable developments in drugs for postoperative sedation of pain, many drugs (Morphine, etc.) have the effect of inhibiting respiration and anesthesia, resulting in not widely used in patients after neurosurgery.…”

Analisis Masalah Keperawatan pada Pasien Post Kraniotomi di RSD Dr. Soebandi Jember (Studi Retrospektif Januari 2016 – Desember 2017)

“…Kesamaan masalah keperawatan utama yang muncul yaitu nyeri akut. Nyeri post kraniotomi paling banyak berpengaruh di dunia dan nyeri post kraniotomi diidentifikasi sebagai prioritas kesehatan masyarakat (Guilkey et al, 2016). Masalah pernapasan menjadi perhatian utama karena komplikasi paru yang berpengaruh pada pernapasan terutama komplikasi paru pasca operasi, merupakan penyebab penting morbiditas dan mortalitas pada pasien bedah saraf (Misra, 2016).…”