The treatment of postcraniotomy pain.
10.17085/apm.2016.11.4.327
- Author:
Jinhye MIN
1
Author Information
1. Department of Anesthesiology and Pain Medicine, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea. jhmin@mjh.org
- Publication Type:Review
- Keywords:
Craniotomy;
Postoperative pain
- MeSH:
Analgesics, Opioid;
Anesthetics, Local;
Brain;
Carbon Dioxide;
Craniotomy;
Humans;
Intracranial Pressure;
N-Methylaspartate;
Neurosurgeons;
Pain, Postoperative;
Respiratory Insufficiency;
Scalp
- From:Anesthesia and Pain Medicine
2016;11(4):327-336
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Postoperative pain is under-treated, and especially postcraniotomy pain is under-treated due to the fear of missing postoperative neurologic complications, and the fear of increased intracranial pressure secondary to elevated arterial carbon dioxide tension caused by respiratory depression. However, it continues to be commonly observed, is frequently severe, and if unrelieved, it may cause distress for the neurosurgical patients and serious complications in the operated brains. Many contributing factors affect postcraniotomy pain, including anatomical, surgical, anesthetic, and patient related factors. Diverse modalities are used for relieving the pain such as certain surgical techniques, nerve and scalp blocks with local anesthetics, many drugs – nonsteroidal anti-inflammatory drugs, gabapentinoids, N-methyl-D-aspartate antagonists, and opioids, but individually none of these modalities have been proved to be the best and universally applicable. For proper treatment and management of postcraniotomy pain, it is necessary to have a patient oriented, evidence-based, well-organized guideline for neuroanesthesiologists, neurosurgeons, and postcraniotomy patients.
