Pain after craniotomy: A time for reappraisal?

Saha, Pradipta; Chattopadhyay, Shibram; Rudra, A; Roy, Subhas Chandra

doi:10.4103/0970-5333.114853

Cited by 7 publications

(5 citation statements)

References 1 publication

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“…About 10% to 20% of patients undergoing craniotomy suffered from severe pain and more than 30% experienced moderate pain as per Guilfoyle et al (Guilfoyle et al, 2013). This can prolong length of stay in the hospital, a sudden increase in heart rate and blood pressure leads to potential morbidity and mortality due to an increase in intracranial pressure in patients (Tuchinda et al, 2010;Chattopadhyay et al, 2013). Generally, opioids are used to eliminate hemodynamic fluctuations and reduce postoperative pain, however, it can delay recovery time, contribute to long sedation, and interfere with postoperative neurological examinations.…”

Section: Anesthesia-relatedmentioning

confidence: 98%

Management of anesthesia in cerebellum cavernous with developmental venous anomaly that causes acute cerebellar bleeding following COVID-19 infection

Desiree

Santosa

2022

ijhs

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Cerebellum cavernous also known as cavernous hemangioma is a vascular malformation of the cerebellum, usually with characteristics that appear on the magnetic resonance image (MRI). Cerebellum cavernous is the third most malformation of the cerebellum after venous anomalies and capillary telangiectasis with an incidence of 0.5% of the General population usually not noticed until a hemorrhagic event occurs. Cavernomas can be seen in conjunction with developmental venous anomaly (DVAs) in 20% (range 20%-40%) cases, in which case they are known as mixed vascular malformations. We describe anaesthetic management in a 28-year-old woman with cerebellum cavern with developmental venous anomaly (DVAs) that causes acute bleeding. Occipital craniectomy for cerebellar tumor resection is performed using neuronavigation under total intravenous anesthesia and scalp block using 0.5% ropivacaine without complications. The surgery lasts for six hours and the cavernomas can be removed completely. The patient was discharged home on the fifth day of postoperative surgery with no neurological deficit.

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Section: Anesthesia-relatedmentioning

confidence: 98%

Management of anesthesia in cerebellum cavernous with developmental venous anomaly that causes acute cerebellar bleeding following COVID-19 infection

Desiree

Santosa

2022

ijhs

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“…9,10 Effective management of postcraniotomy pain may also be compromised because few nonpharmacologic strategies for pain management have been developed and tested in this population. 11,12 Pain management for craniotomy patients following surgery typically includes the use of opioids, [13][14][15][16] α2 adrenergic agonists 12 such as dexmedetomidine, 13,15,17,18 and adjuvant pain medications. 19,20 The addition of atypical analgesics, such as cyclooxygenase 2 inhibitors, to hospitalized patients' pain regimens may decrease adverse effects and increase earlier mobilization, thereby reducing hospital stay and associated costs.…”

mentioning

confidence: 99%

“…Pain management for craniotomy patients following surgery typically includes the use of opioids, 13–16 α2 adrenergic agonists 12 such as dexmedetomidine, 13,15,17,18 and adjuvant pain medications 19,20 . The addition of atypical analgesics, such as cyclooxygenase 2 inhibitors, to hospitalized patients’ pain regimens may decrease adverse effects and increase earlier mobilization, thereby reducing hospital stay and associated costs 9,21,22 .…”

mentioning

confidence: 99%

“…38,39 In addition, unrelieved pain may cause agitation and sympathetic stimulation resulting in increased blood pressure and swelling. 22 Moreover, acute postcraniotomy pain in brain tumor patients is associated with greater healthcare burden including longer lengths of stay and higher costs of hospitalization, 12 delayed mobilization, 12 higher rates of disability, and poor perceived quality of life due to increased anxiety and depression. 8,[39][40][41] Despite calls for the development of better strategies to manage postcraniotomy pain, little is known about patient perspectives on pain management following surgery.…”

mentioning

confidence: 99%

“…Moreover, nausea and vomiting resulting from analgesic administration can increase blood pressure and contribute to an increased risk of aspiration 9,10 . Effective management of postcraniotomy pain may also be compromised because few nonpharmacologic strategies for pain management have been developed and tested in this population 11,12 …”

mentioning

confidence: 99%

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Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients

Winton

Draucker

2020

Cancer Nurs

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Background Brain tumors account for the majority of central nervous system tumors, and most are removed by craniotomies. Many postcraniotomy patients experience moderate or severe pain after surgery, but patient perspectives on their experiences with pain management in the hospital have not been well described. Objective The aim of this study was to describe how patients who have undergone a craniotomy for brain tumor removal experience pain management while hospitalized. Methods Qualitative descriptive methods using semistructured interviews were conducted with patients on a neurological step-down unit in an urban teaching hospital in the Midwest United States. Interviews focused on how patients experienced postcraniotomy pain and how it was managed. Narratives were analyzed with standard content analytic procedures. Results Twenty-seven participants (median age, 58.5 years; interquartile range, 26–41 years; range, 21–83 years) were interviewed. The majority were white (n = 25) and female (n = 15) and had an anterior craniotomy (n = 25) with sedation (n = 17). Their pain experiences varied on 2 dimensions: salience of pain during recovery and complexity of pain management. Based on these dimensions, 3 distinct types of pain management experiences were identified: (1) pain-as-nonsalient, routine pain management experience; (2) pain-as-salient, routine pain management experience; and (3) pain-as-salient, complex pain management experience. Conclusions Many postcraniotomy patients experience their pain as tolerable and/or pain management as satisfying and effective; others experience pain and pain management as challenging. Implications for Practice Clinicians should be attuned to needs of patients with complex pain management experiences and should incorporate good patient/clinician communication.

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Opioid consumption after levobupivacaine scalp nerve block for craniosynostosis surgery

Bracho

Neto

Grousson

et al. 2014

Acta Anaesthesiologica Taiwanica

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Scalp nerve block can be proposed as a complement to the routine craniosynostosis anesthetic protocol, because it is easy to perform, seems to reduce the need for supplementary opioids during the perioperative period, and can reduce the risk of developing acute opioid tolerance and chronic pain. In the event of trigonocephaly or craniofacial reconstruction, a complementary infraorbital nerve block can be added.

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Pain after craniotomy: A time for reappraisal?

Cited by 7 publications

References 1 publication

Management of anesthesia in cerebellum cavernous with developmental venous anomaly that causes acute cerebellar bleeding following COVID-19 infection

Management of anesthesia in cerebellum cavernous with developmental venous anomaly that causes acute cerebellar bleeding following COVID-19 infection

Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients

Opioid consumption after levobupivacaine scalp nerve block for craniosynostosis surgery

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