Local anesthetics for brain tumor resection: current perspectives.

Area of Science:

• Neurosurgery
• Anesthesiology
• Pain Management

Background:

• Craniotomy for brain tumor resection is common, with variable postoperative pain.
• Pain management options include general anesthesia, sedation with local anesthesia, or local anesthesia alone.
• Postoperative pain intensity varies widely, with infratentorial surgery being a predictor of higher pain scores.

Purpose of the Study:

• To review the benefits of local anesthetics in craniotomy for brain tumor resection.
• To explore different local anesthesia techniques for craniotomy.
• To assess the impact of local anesthesia on postoperative pain and opioid consumption.

Main Methods:

• Review of literature on local anesthetic use in craniotomy.
• Discussion of nerve block and local infiltration techniques for scalp anesthesia.
• Examination of intravenous lidocaine for perioperative cough prevention.

Main Results:

• Local anesthesia is associated with reduced postoperative pain intensity and opioid requirements.
• It can aid in preventing the development of chronic pain.
• Intravenous lidocaine is effective in preventing coughing during emergence from anesthesia.

Conclusions:

• Local anesthetics are valuable in multimodal pain management for craniotomy patients.
• Both direct nerve blocks and local infiltration are viable techniques, though comparative data is lacking.
• Local anesthesia is crucial for awake craniotomy and improves patient comfort and recovery.