Related Experiment Video

Updated: May 4, 2026

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
07:23

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities

Published on: July 29, 2014

34.3K

Comparative analysis of analgesic mechanisms in craniotomy pediatric patients: a scoping review

Abigail Jenkins1, Gillian Witten2, Faraaz Azam2

  • 1Department of Neurological Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75235, USA. Abigail.Jenkins@UTSouthwestern.edu.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 23, 2026
PubMed

Insights

Effective pediatric craniotomy pain management requires multimodal, opioid-minimizing strategies. Non-opioid therapies and nerve blocks reduce pain and opioid use, reserving opioids for breakthrough pain.

Area of Science:

  • Neurosurgery
  • Pediatric Anesthesiology
  • Pain Management

Background:

  • Craniotomy is invasive, necessitating effective postoperative pain control in pediatric patients.
  • Standardized guidelines for pediatric neurosurgical pain management are limited.
  • Opioid use is prevalent but associated with risks.

Purpose of the Study:

  • To review and evaluate postoperative analgesic strategies for children undergoing craniotomy.
  • To identify effective pain management approaches.
  • To assess the efficacy of opioid-sparing techniques.

Main Methods:

  • Scoping review of 24 studies (5 case reports/series, 19 investigations).
  • Included 1,567 pediatric patients (mean age 6.3 years).
  • Analyzed opioid and non-opioid analgesic strategies.

Main Results:

  • Opioids (morphine, codeine) were used in 70.7% of cases.
  • Non-opioid options included NSAIDs, acetaminophen, sedatives, local anesthetics, and nerve blocks.
  • Multimodal and single-agent regimens showed similar clinical improvement (61.7%).
  • Randomized trials indicated scheduled non-opioids, nerve blocks, and local anesthetics reduced pain and opioid needs without complications.

Conclusions:

  • Multimodal, opioid-minimizing strategies are supported by current evidence.
  • Opioids should be reserved for breakthrough pain.
  • Further research is needed to refine pediatric craniotomy pain management.

Keywords:
AnalgesicsCraniotomyOpioidsPain managementPediatric

More Related Videos

Intracranial Pharmacotherapy and Pain Assays in Rodents02:26

Intracranial Pharmacotherapy and Pain Assays in Rodents

Published on: April 9, 2019

6.0K
Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat07:58

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

270

Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
2.0K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
1.0K
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
3.3K
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.5K
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.1K
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
1.0K