Objectives: The prevalence of moderate to severe pain is high in patients following craniotomy. Although optimal analgesic therapy is mandatory, there is no consensus regarding analgesic regimen for post-craniotomy pain exists. This study aimed to investigate the effects of morphine and non-opioid analgesics on postcraniotomy pain.
Patients And Methods: This prospective, randomized, double blind, placebo controlled study included eighty three patients (ASA 1, II, and III) scheduled for elective supratentorial craniotomy. Intravenous dexketoprofen, paracetamol and metamizol were investigated for their effects on pain intensity, morphine consumption and morphine related side effects during the first 24h following supratentorial craniotomy. Patients were treated with morphine based patient controlled analgesia (PCA) for 24h following surgery and randomized to receive supplemental IV dexketoprofen 50mg, paracetamol 1g, metamizol 1g or placebo. The primary endpoint was pain intensity, secondary endpoint was the effects on morphine consumption and related side effects.
Results: When the whole study period was analyzed with repeated measures of ANOVA, the pain intensity, cumulative morphine consumption and related side effects were not different among the groups (p>0.05).
Conclusion: This study showed that the use of morphine based PCA prevented moderate to severe postoperative pain without causing any life threatening side effects in patients undergoing supratentorial craniotomy with a vigilant follow up during postoperative 24h. Although we could not demonstrate statistically significant effect of supplemental analgesics on morphine consumption, it was lower in dexketoprofen and metamizol groups than control group.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clineuro.2016.04.026 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Surgical interventions for spontaneous supratentorial intracerebral haemorrhage: a systematic review and network meta-analysis.
EClinicalMedicine
January 2025
Department of Neurosurgery and Chinese Evidence-Based Medicine Centre and Cochrane China Centre and MAGIC China Centre and IDEAL China Centre, West China Hospital, Sichuan University, Chengdu, China.
Background: Surgical interventions for spontaneous supratentorial intracerebral haemorrhage (ICH) include conventional craniotomy (CC), decompressive craniectomy (DC), and minimally invasive surgery (MIS), with the latter encompassing endoscopic surgery (ES) and minimally invasive puncture surgery (MIPS). However, the superiority of surgery over conservative medical treatment (CMT) and the comparative benefits of different surgical procedures remain unclear. We aimed to evaluate the efficacy and safety of various surgical interventions for treating ICH.
View Article and Find Full Text PDFA multi-center, open-label, randomized clinical trial evaluating the preventive effect of perampanel on craniotomy-induced epileptogenesis in seizure-naive patients with supratentorial brain tumors: study protocol for a GRAMPAS trial.
Trials
December 2024
Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, Japan.
Background: Early seizures after craniotomy are significant perioperative complications that can adversely impact patient outcomes. Despite current guidelines advising against the routine use of antiseizure drugs for seizure after craniotomy prevention due to limited efficacy data, many clinicians continue prescribing them. This discrepancy highlights the need for robust evidence to guide clinical practice.
View Article and Find Full Text PDFIntraventricular Glioblastoma in a Neonate: A Case Report and Literature Review.
Cureus
November 2024
Department of Neurosurgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU.
Article Synopsis
- Intraventricular glioblastoma multiforme (GBM) is an uncommon brain tumor, especially in infants, with this case detailing a 54-day-old baby who presented with symptoms of increased head size and vomiting.
- The infant underwent surgery to remove the tumor, which was confirmed to be a pediatric-type glioblastoma through histopathological examination.
- Over a 10-year follow-up, the child experienced developmental delays and seizures but showed no signs of tumor recurrence, indicating a rare instance of long-term survival after this aggressive cancer.
Herniation secondary to critical cerebrospinal fluid hypovolemia after supratentorial craniotomy: a single-center case series.
Neurol Sci
December 2024
Department of Neurosurgery, Beijing Shunyi District Hospital, Capital Medical University, Beijing, 101300, China.
Background: Critical cerebrospinal fluid hypovolemia (CCSFH) is a rare postcraniotomy condition in patients with acute supratentorial brain injury, often mistaken for intracranial hypertension. This article aims to enhance awareness of CCSFH by describing its clinical and radiological characteristics.
Methods: Between January 2019 and November 2023, 330 consecutive patients with acute critical brain injury underwent supratentorial craniotomy.
Safety and efficacy of a 3D-printed external cranial protection device in preventing complications after unilateral supratentorial decompressive craniectomy: A retrospective cohort study.
Medicine (Baltimore)
December 2024
Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China.
Article Synopsis
- The study examined the viability and impact of 3D-printed external cranial protection devices (ECPD) in preventing complications after unilateral decompressive craniectomy (DC).
- A cohort of 44 patients was evaluated, with 24 using the ECPD and 20 receiving standard treatment, showing no significant differences in overall outcomes but a notable reduction in specific complications like subdural effusion for the ECPD group.
- Results suggest that while the ECPD is safe and helps reduce some complications post-DC, it does not significantly enhance patient prognosis, indicating the need for additional research.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!