Postoperative Craniotomy Pain in Emergent versus Non-emergent Cases

Postoperative pain control in craniotomies poses multiple challenges. Pain must be addressed, but the use of medications must be weighed against risks. Craniotomies risk neurologic injury and so postoperative examinations are critical. Medications used to address pain can alter the neurological examination or cause bleeding leading to misdiagnosis of complications.

Determine if there is a significant difference in postoperative pain from emergent craniotomies vs. non-emergent craniotomies Methods: A retrospective review included 102 cases performed from 2010-2016; pain scores were compared on post-operative days one, two, and three between emergent and non-emergent craniotomies.

Pain scores for emergent cases on post-operative days one through three were 5.1 (standard deviation (SD)=2.9), 5.9 (SD=2.1), 4.7 (SD=3.0) respectively. Pain scores for non-emergent cases on post-operative days one through three were 5.7 (SD=2.6), 4.8 (SD=2.8), and 4.6 (SD=3.0) respectively. A one-way analysis of variance (ANOVA) was conducted to compare pain scores between groups for each post-operative day. On post-operative day, one there was no significant difference between the groups [F(1,100)=0.49, p=0.485]. On post-operative day two, there was no significant difference between the groups [F(1,100)=2.17, p=0.143]. On post-operative day three, there was no significant difference between the groups [F(1,98)=0.002, p=0.957].

There is no significant difference in the level of pain on postoperative days one through three between emergent and non-emergent craniotomy patients.