Regional Scalp Block for Postcraniotomy Analgesia

Guilfoyle, Matthew R.; Helmy, Adel; Duane, Derek; Hutchinson, Peter J.

doi:10.1097/01.sa.0000441000.19915.95

Cited by 6 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accordingly, most research on postcraniotomy pain has been conducted in other countries. Research to date has focused solely on pharmacological intervention and fails to explore the multidimensional nature of pain through comprehensive assessment (Leslie & Troedel 2002, Nemergut et al 2007, Hansen et al 2011, Guilfoyle et al 2013. Although pharmacological interventions exist, no one therapeutic medication has been identified as most efficacious (National Pharmaceutical Council 2003, Paolino et al 2006, Institute of Medicine Committee on Advancing Pain Research, C. andEducation 2011, Saha et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Integrative review: postcraniotomy pain in the brain tumour patient

Guilkey

Carpenter

et al. 2016

Journal of Advanced Nursing

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Integrative review: postcraniotomy pain in the brain tumour patient

Guilkey

Carpenter

et al. 2016

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…9 A previous meta-analysis published in 2013 identified a positive impact of regional scalp block for postcraniotomy analgesia, but the RCTs included were small and of limited methodological quality. 45 Up to now, only the 3 RCTs included in our study were performed, which seem not to provide strong evidence on scalp block analgesic efficacy. [24][25][26] During the first 6 postoperative hours, the analgesic efficacy of scalp infiltration applied prior to surgery was superior to that performed upon skin closure, 24 while the results from scalp block applied before awakening 25 vs. placebo presented conflicting results, as the positive results in terms of pain and PONV control can be questioned by the equivalent overall consumption of fentanyl between groups.…”

Section: Scalp Infiltration or Scalp Nerve Blockmentioning

confidence: 97%

Postoperative Pain Control Following Craniotomy: A Systematic Review of Recent Clinical Literature

2017

View full text Add to dashboard Cite

No definite recommendations can be made based on this systematic review of pharamacological interventions following craniotomy due to significant divergence in the methodology of available studies. Limited evidence on scalp infiltration/block suggests an adequate analgesic effect in the early postoperative period. Analgesic efficacy of dexmedetomidine and multipoint electro-acupuncture needs further evaluation.

show abstract

“…The zygomaticotemporal nerve, a branch of the maxillary division of the trigeminal nerve, is given optionally to patients undergoing an elevation of the temporalis muscle and that too unilateral. 2 We have not included it in our study because the standardization of the incision site was not performed, and standard scalp block as per the institutional protocol was performed. The limitation of our study is that all craniotomies were chosen irrespective of the site of incision, and the use of this technique for any one particular surgery has not been reported earlier.…”

mentioning

confidence: 99%