Pain following craniotomy is challenging. Preoperative anxiety can be one of the controllable factors for prevention of post-craniotomy pain. The main objective of this prospective observational study is to determine this relationship in patients undergoing scheduled craniotomy from February to June 2021. After excluding patients with Mini-Mental State Examination (MMSE) ≤ 24 points, we administered a preoperative State Trait Anxiety Inventory (STAI) questionnaire. We recorded the patient's analgesic assessment using the Numerical Rating Score (NRS) at 1, 8, 24, and 48 h after surgery. A total of 73 patients were included in the study. Twelve others were excluded due to a MMSE ≤ 24 points. The main predictors for NRS postoperatively at 1, 8, 24, and 48 h were STAI A/E score, male gender, youth, and depression. We identified a cut-off point of 24.5 in STAI A/E for predicting a NRS > 3 (sensitivity 82% and specificity 65%) at 24 h postoperative and a cut-off of 31.5 in STAI A/R (sensitivity 64% and specificity 77%). In conclusion, preoperative STAI scores could be a useful tool for predicting which patient will experience at least moderate pain after craniotomy. The identification of these patients may allow us to highlight psychological preparation and adjuvant analgesia.
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http://dx.doi.org/10.3390/jcm11030556 | DOI Listing |
Pediatr Surg Int
December 2024
Department of Pediatric Surgery, Shamir Medical Center, Be'er Ya'acov, Israel.
Purpose: Minimal incision procedures have been recommended for pediatric pilonidal sinus disease, based on small studies with short follow-up. We aimed to describe medium-term outcomes of trephination in a large cohort.
Methods: Retrospective chart review and additional concluding telephone interviews for all children who underwent primary trephination in our institution over 5.
J Pain Res
December 2024
Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.
Objective: The current landscape is characterized by a dearth of effective, safe, simple, and noninvasive methods for preventing pain following craniotomy. This clinical trial seeks to evaluate the efficacy profile of preemptive application of a topical 5% lidocaine patch in alleviating post-craniotomy pain.
Methods: This was a multi-centric, prospective randomized placebo-controlled triple-blind clinical trial.
J Clin Med
November 2024
Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
This study aimed to develop and validate a stratified risk model for predicting high opioid use in patients with acute brain injury due to stroke or traumatic brain injury (TBI) admitted to a neurocritical care intensive care unit. : We examined the factors associated with the use of high-opioids (≥75th quartile, ≥17.5 oral morphine equivalent/ICU day) in a retrospective cohort study including patients with acute ischemic stroke, spontaneous intracerebral hemorrhage, spontaneous subarachnoid hemorrhage, and TBI.
View Article and Find Full Text PDFCureus
November 2024
Medicine, Plainview Hospital, Plainview, USA.
This case presents a 12-year-old male patient diagnosed with preseptal cellulitis that progressed to a subperiosteal orbital abscess and eventually intracranial extension, despite outpatient antibiotic therapy. Initially treated with oral antibiotics for left eyelid swelling and pain, his condition worsened, prompting hospital admission and eventual surgical intervention. Imaging revealed multiple abscesses and a hematoma, causing mass effect on the globe and extraocular muscles.
View Article and Find Full Text PDFEpilepsy Behav
December 2024
Translational Neuropharmacology Lab, NIFE, Department of Experimental Otology of the ENT Clinics, Hannover Medical School, Hannover, Germany. Electronic address:
The ethical use of laboratory animals requires that the benefits of an experimental study are carefully weighed against potential harm to the animals. In traumatic brain injury (TBI) research, ethical concerns are especially relevant to severe TBI, after which animals may experience suffering, depending on the implementation of refinement measures such as (1) postsurgical analgesia during the initial period following TBI and (2) humane endpoints. However, despite the frequent use of rodent models such as fluid percussion injury (FPI) and controlled cortical impact (CCI) in rats or mice, there is only one recent study that applied assessment of welfare to a severe TBI model, the FPI model in rats.
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