Postoperative analgesia for supratentorial craniotomy

Area of Science:

• Neurosurgery
• Anesthesiology
• Pain Management

Background:

• Post-craniotomy pain is a significant clinical challenge.
• Optimal pain management strategies remain debated.
• Non-opioid analgesics are explored as adjuncts to opioid-based regimens.

Purpose of the Study:

• To evaluate the efficacy of supplemental intravenous dexketoprofen, paracetamol, and metamizol in managing post-craniotomy pain.
• To assess the impact of these non-opioid analgesics on morphine consumption and related side effects.
• To compare these interventions against a placebo in patients receiving morphine-based patient-controlled analgesia (PCA).

Main Methods:

• Prospective, randomized, double-blind, placebo-controlled study.
• Eighty-three patients undergoing elective supratentorial craniotomy.
• Morphine-based PCA for 24 hours with supplemental IV dexketoprofen, paracetamol, metamizol, or placebo.

Main Results:

• No statistically significant differences in pain intensity, morphine consumption, or side effects were observed among the groups.
• Pain intensity, morphine consumption, and side effects were comparable across all treatment arms.

Conclusions:

• Morphine-based PCA effectively controlled moderate to severe post-craniotomy pain.
• Supplemental non-opioid analgesics did not significantly alter morphine consumption or pain levels in this study.
• Dexketoprofen and metamizol groups showed a trend towards lower morphine consumption compared to placebo.