Nerve Blocks for Craniotomy

Stieger, Andrea; Romero, Carolina S.; Andereggen, Lukas; Heisenberg, Daniel; Urman, Richard D.; Luedi, Markus M.

doi:10.1007/s11916-024-01236-4

Cited by 4 publications

(1 citation statement)

References 51 publications

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“…Therefore, it is essential to effectively manage acute pain [10][11][12][13][14]. Although opioids are often used in the management of postoperative pain due to their effectiveness in alleviating even severe pain, their side effects, such as sedation, respiratory depression, postoperative nausea and vomiting (PONV) and impaired bowel function can extend the duration of hospitalization [15].…”

Section: Introductionmentioning

confidence: 99%

Adjuvant Analgesics in Acute Pain – Evaluation of Efficacy

Kummer,

Lüthi,

Klingler

et al. 2024

Curr Pain Headache Rep

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Purpose of the Review Acute postoperative pain impacts a significant number of patients and is associated with various complications, such as a higher occurrence of chronic postsurgical pain as well as increased morbidity and mortality. Recent Findings Opioids are often used to manage severe pain, but they come with serious adverse effects, such as sedation, respiratory depression, postoperative nausea and vomiting, and impaired bowel function. Therefore, most enhanced recovery after surgery protocols promote multimodal analgesia, which includes adjuvant analgesics, to provide optimal pain control. In this article, we aim to offer a comprehensive review of the contemporary literature on adjuvant analgesics in the management of acute pain, especially in the perioperative setting. Summary Adjuvant analgesics have proven efficacy in treating postoperative pain and reducing need for opioids. While ketamine is an established option for opioid-dependent patients, magnesium and α2-agonists have, in addition to their analgetic effect, the potential to attenuate hemodynamic responses, which make them especially useful in painful laparoscopic procedures. Furthermore, α2-agonists and dexamethasone can extend the analgesic effect of regional anesthesia techniques. However, findings for lidocaine remain inconclusive.

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Section: Introductionmentioning

confidence: 99%

Adjuvant Analgesics in Acute Pain – Evaluation of Efficacy

Kummer,

Lüthi,

Klingler

et al. 2024

Curr Pain Headache Rep

Self Cite

View full text Add to dashboard Cite

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Cannabinoids for Acute Pain Management: Approaches and Rationale

Botea,

Andereggen,

Urman

et al. 2024

Curr Pain Headache Rep

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Purpose of the Review Acute pain management remains a challenge and postoperative pain is often undermanaged despite many available treatment options, also including cannabinoids. Recent Findings In the light of the opioid epidemic, there has been growing interest in alternative care bundles for pain management, including cannabinoids as potential treatment to decrease opioid prescribing. Despite the lack of solid evidence on the efficacy of cannabinoids, their use among patients with pain, including those using opioids, is currently increasing. This use is supported by data suggesting that cannabinoids could potentially contribute to a better pain management and to a reduction in opioid doses while maintaining effective analgesia with minimum side effects. Summary The scientific basis for supporting the use of cannabis is extensive, although it does not necessarily translate into relevant clinical outcomes. The use of cannabinoids in acute pain did not always consistently show statistically significant results in improving acute pain. Large randomized, controlled trials evaluating diverse cannabis extracts are needed in different clinical pain populations to determine safety and efficacy.

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An update on the perioperative management of postcraniotomy pain

Dean,

McCullough,

Papangelou

2024

Current Opinion in Anaesthesiology

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Purpose of review Pain after craniotomy is often severe and undertreated. Providing adequate analgesia while avoiding medication adverse effects and physiological complications of pain remains a perioperative challenge. Recent findings Multimodal pain management includes regional anesthesia and analgesic adjuncts. Strategies aim to reduce or eliminate opioids and the associated side effects. Many individual pharmacologic interventions have been studied with beneficial effects on acute pain following craniotomy. Evidence has been accumulating in support of scalp blockade, nonsteroidal anti-inflammatory drugs (NSAIDs), dexmedetomidine, paracetamol, and gabapentinoids. The strongest evidence supports scalp block in reducing postcraniotomy pain and opioid requirements. Summary Improving analgesia following craniotomy continues to be a challenge that should be managed with multimodal medications and regional techniques. Additional studies are needed to identify the most effective regimen, balancing efficacy and adverse drug effects.

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Nerve Blocks for Craniotomy

Cited by 4 publications

References 51 publications

Adjuvant Analgesics in Acute Pain – Evaluation of Efficacy

Adjuvant Analgesics in Acute Pain – Evaluation of Efficacy

Cannabinoids for Acute Pain Management: Approaches and Rationale

An update on the perioperative management of postcraniotomy pain

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