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Management of Post-craniotomy Pain in Elective Cases: A Randomized Controlled Trial
Kumar Abhinav1, Dikpal Jadhav2, Uday B Andar3
1Department of Neurosurgery, Lilavati Hospital and Research Centre, Mumbai, IND.
Cureus
|October 31, 2023
Summary
The enhanced recovery after surgery (ERAS) protocol significantly reduced postoperative pain and hospital stay duration for patients undergoing elective craniotomies. This approach offers improved patient outcomes and reduced medical costs.
Area of Science:
- Neurosurgery
- Anesthesiology
- Pain Management
Background:
- Craniotomy procedures are frequently linked with substantial postoperative discomfort.
- Implementing standardized pain management and enhanced recovery after surgery (ERAS) protocols can potentially improve patient-reported outcomes and decrease healthcare expenditures.
Purpose of the Study:
- To prospectively evaluate the efficacy of a neurosurgical ERAS protocol in managing postoperative pain after elective craniotomies.
Main Methods:
- A prospective study involving 128 patients in the ERAS group and 130 in the control group.
- Pain was assessed using the numerical rating scale (NRS) daily from postoperative day 1 until discharge or pain resolution.
Main Results:
- The ERAS group reported significantly lower pain scores on postoperative days 1, 2, and 3 compared to the control group (p < 0.011).
- A higher proportion of ERAS patients experienced mild pain (NRS 1-3), while fewer reported moderate to severe pain (NRS 4-7) (p < 0.001).
- The ERAS protocol was associated with a statistically significant reduction in the length of hospital stay (p < 0.001).
Conclusions:
- The ERAS protocol demonstrates effectiveness in managing postoperative pain following elective craniotomies.
- Adoption of the ERAS protocol can lead to reduced healthcare costs and shorter hospitalizations.
