Perioperative Factors Contributing the Post-Craniotomy Pain: A Synthesis of Concepts

Chowdhury, Tumul; Garg, Rakesh; Sheshadri, Veena; Venkatraghavan, Lakshmikumar; Bergese, Sergio D.; Cappellani, Ronald B.; Schaller, Bernhard

doi:10.3389/fmed.2017.00023

Cited by 39 publications

(49 citation statements)

References 42 publications

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“…Unless postoperative pain is specifically being studied, pain control following surgery is an absolute requirement. The severity of pain following craniotomy has historically been viewed as minimal, but recent data suggests otherwise 23 . This makes the detection of craniotomyrelated pain in animals critically important for refinement, but since species and individual responses to pain are variable, evaluation and treatment of this pain are difficult.…”

Section: Discussionmentioning

confidence: 99%

Evaluating analgesic efficacy and administration route following craniotomy in mice using the grimace scale

Cho

Michalidis

Lecker

et al. 2018

Preprint

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Most research laboratories abide by guidelines and mandates set by their research institution regarding the administration of analgesics to control pain during the postoperative period. Unfortunately, measuring pain originating from the head is difficult, making adequate decisions regarding pain control following stereotaxic surgery problematic. In addition, most postsurgical analgesia protocols require multiple injections over several days, which may cause stress and distress during a critical recovery period. Here we sought to 1) assess the degree of postoperative pain following craniotomy in mice, 2) compare the efficacy of three common rodent analgesics (carprofen, meloxicam and buprenorphine) for reducing this pain and 3) determine whether the route of administration (injected or self-administered through the water supply) influenced pain relief post-craniotomy. Using the mouse grimace scale (MGS), we found that injectable analgesics were significantly more effective at relieving post-craniotomy pain, however, both routes of administration decreased pain scores in the first 24 h post-surgery. Specifically, buprenorphine administered independently of administration route was the most effective at reducing MGS scores, however, female mice showed greater sensitivity to carprofen when administered through the water supply. Although it is necessary to provide laboratory animals with analgesics after an invasive procedure, there remains a gap in the literature regarding the degree of craniotomy-related pain in rodents and the efficacy of alternative routes of administration. Our study highlights the limitations of administering drugs through the water supply, even at doses that are considered to be higher than those currently recommended by most research institutions for treating pain of mild to moderate severity.

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Section: Discussionmentioning

confidence: 99%

Evaluating analgesic efficacy and administration route following craniotomy in mice using the grimace scale

Cho

Michalidis

Lecker

et al. 2018

Preprint

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show abstract

“…A recent review studied several factors such as age and gender, surgical site, surgical technique, psychological factors and tumor characteristics, but the results are conflicting and inconclusive. 8 The surgical site has turned out to be the only reliably identified factor: infratentorial surgery tends to be more painful and requires a higher cumulative opioid dose than supratentorial surgery, possibly because of the surgical-induced stretch and trauma of the neck muscle mass. 9 , 10 A review by de Gray and Matta provides further details about the pathogenesis of postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

Local anesthetics for brain tumor resection: current perspectives

Potters¹,

Klimek²

2018

LRA

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This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain. The only identified causative factor predicting higher postoperative pain scores is infratentorial surgery. Postoperative analgesia can be achieved with multimodal pain management where local anesthesia is associated with lower postoperative pain intensity, reduction in opioid requirement and prevention of development of chronic pain. In awake craniotomy patients, sufficient local anesthesia is a cornerstone of the procedure. An awake craniotomy and brain tumor resection can be carried out completely under local anesthesia only. However, the use of sedative drugs is common to improve patient comfort during craniotomy and closure. Local anesthesia for craniotomy can be performed by directly blocking the six different nerves that provide the sensory innervation of the scalp, or by local infiltration of the surgical site and the placement of the pins of the Mayfield clamp. Direct nerve block has potential complications and pitfalls and is technically more challenging, but mostly requires lower total doses of the local anesthetics than the doses required in surgical-site infiltration. Due to a lack of comparative studies, there is no evidence showing superiority of one technique versus the other. Besides the use of other local anesthetics for analgesia, intravenous lidocaine administration has proven to be a safe and effective method in the prevention of coughing during emergence from general anesthesia and extubation, which is especially appreciated after brain tumor resection.

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“…Nyeri memburuk dalam beberapa hari pertama pasca operasi (Saha et al, 2013). 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).…”

Section: Metode Penelitianunclassified

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

A'la¹,

Dewi²,

Siswoyo³

2019

jkry

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Bedah kraniotomi merupakan pembedahan pembukaan kranium untuk meningkatan akses pada struktur intrakranial yang berisiko terhadap kerusakan jaringan dan komplikasi lainnya. Manajemen post operasi dalam perawatan dapat dilakukan dengan melakukan proses keperawatan. Masalah keperawatan merupakan dasar untuk diagnosis keperawatan pada rencana perawatan perawat. Tujuan penelitian ini adalah untuk menganalisis gambaran masalah keperawatan pasien post kraniotomi di RSD dr. Soebandi Kabupaten Jember. Jenis penelitian ini adalah deskriptif kuantitatif pada variabel masalah keperawatan menggunakan pendekatan studi retrospektif dengan metode simple random sampling. Sampel penelitian ini adalah 94 rekam medis pasien post kraniotomi yang dihitung menggunakan rumus slovin dari jumlah populasi pada Januari 2016-Desember 2017. Hasil penelitian menunjukkan bahwa masalah keperawatan utama pada pasien post kraniotomi adalah nyeri akut (58,51%), ketidakefektifan bersihan jalan napas (25,53%), dan ketidakefektifan pola napas (15,96%). Diagnosis keperawatan yang berdasarkan indikator dengan mencerminkan PES/PE sebanyak 39 (41,49%) dan yang tidak mencerminkan PES/PE sebanyak 55 (58,51%). Perawat memiliki peranan penting dalam manajemen post operasi khususnya pada asuhan keperawatan. Masalah keperawatan perlu dirumuskan dengan memperhatikan data-data yang mendukung munculnya masalah keperawatan pada pasien guna meningkatkan kualitas asuhan keperawatan

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Perioperative Factors Contributing the Post-Craniotomy Pain: A Synthesis of Concepts

Cited by 39 publications

References 42 publications

Evaluating analgesic efficacy and administration route following craniotomy in mice using the grimace scale

Evaluating analgesic efficacy and administration route following craniotomy in mice using the grimace scale

Local anesthetics for brain tumor resection: current perspectives

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

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