Pain Assessment in Brain Tumor Patients after Elective Craniotomy

Abstract

ObjectiveThis study was performed to assess the postoperative pain of brain tumor patients who underwent elective craniotomy and to evaluate the factors associated with pain intensity.MethodsFrom January 2010 to December 2011, 47 patients with newly diagnosed brain tumors who underwent craniotomy were enrolled. The postoperative pain status was assessed daily until discharge using the visual analogue scale (VAS).ResultsThe study participants comprised of 22 males and 25 females with ages ranging from 18-76 years (median age, 50 years). Patients were divided into two groups: the painful group included patients who had a VAS score of more than 3 during their hospital stay after the craniotomy, and the tolerable group included patients who had a VAS score of 1 to 3 during their hospital stay. There were no differences between the two groups in terms of age, sex, location of surgery, history of diabetes, hypertension and smoking, body mass index, and hospital stay. Univariate analysis revealed that operating time, length of wound, head fixation, and perioperative administration of opioid were not associated with the intensity of postoperative pain. Daily assessment of VAS revealed the two peaks of pain on the operation day and the 4th postoperative day. The intensity of pain during the ambulation period was higher than that during intensive care unit (ICU) stay.ConclusionPain following elective craniotomy for brain tumor removal is insufficiently managed, especially after discharge from the ICU. More attention needs to be paid to patients' pain throughout the hospital stay.

Preoperative headache in patients submitted to unrupted brain aneurysm clamping

“…This might be the explanation for the predominance of females in our study. Mean age was 47.6 years, with emphasis to age group above 45 years, which confirms other studies carried out with patients submitted to craniotomy 8,9 . AH and DM were common among studied patients.…”

“…Most patients had preoperative moderate, pulsing and frontal headache. Studies evaluating the prevalence of pain in patients submitted to craniotomy had high frequency of preoperative pain with similar characteristics [8][9][10][11][12][13][14] . The presence of aneurysm might have influenced pain pulsing character and frontal location.…”

“…In addition, they decrease physical efforts and consequently pain. Pain intensity may increase when patients perform simple activities such as standing up or walking 9 , with risk of early aneurysm rupture. In our study, physical effort and shaking of head were associated to pain worsening.…”

Risk factors governing the development of cerebral vein and dural sinus thrombosis after craniotomy in patients with intracranial tumors

“…3,5,23,30 However, in the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) conducted by Ferro et al, headaches were observed in 88.8% of patients developing spontaneous CVT. 14 To avoid insufficient management of postoperative headaches, 20 our institutional standard of care routinely calls for the administration of postoperative analgesia to patients, which may hinder the clinical diagnosis of CVT (i.e., via the suppression of a critical presenting symptom). Moreover, seizures were observed in 39.5% of all patients within the ISCVT.…”

Analisis Masalah Keperawatan pada Pasien Post Kraniotomi di RSD Dr. Soebandi Jember (Studi Retrospektif Januari 2016 – Desember 2017)

“…Kepercayaan yang terdahulu menyebutkan bahwa nyeri post kraniotomi merupakan hal yang minim terjadi, berbanding terbalik dengan saat ini yaitu data terbaru menunjukkan sebaliknya (Chowdhury et al, 2017). Hal ini bisa disebabkan karena kurangnya pemahaman yang menyeluruh tentang berbagai faktor perioperatif dan pasien dapat mempengaruhi insidensi keparahan intensitas nyeri dan untuk mengatasi hal tersebut dibutuhkan pendekatan terhadap nyeri akut post kraniotomi (Flexman dan Gelb, 2010).Intensitas nyeri yang dialami oleh pasien post kraniotomi berpuncak pada hari operasi dan hari ke-4 pasca operasi (Kim et al, 2013).…”