Carbamazepine improves perioperative outcomes in patients with tentorial meningiomas

Postoperative pain management is critical for patients undergoing surgery for tentorial meningiomas due to the involvement of trigeminal nerve innervation in this region, which often results in severe pain. This study aimed to evaluate the efficacy and safety of carbamazepine (CBZ) in reducing postoperative pain, analgesic consumption, and hospital stay in these patients.

This retrospective study included consecutive patients with tentorial meningiomas who underwent surgical resection between March 2021 and August 2023 at the Second Affiliated Hospital of Zhejiang University. Patients were divided into two groups, with the control group receiving nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids as needed for pain management, while the CBZ group was additionally treated with CBZ at a dosage of 200 mg twice daily postoperatively. Data collected included baseline demographics, postoperative inflammatory markers, liver function, length of hospital stay, total hospital charges, analgesic consumption, and daily pain score.

A total of 42 patients were included in the study, with 22 in the control group and 20 in the CBZ group. Although the CBZ group had shorter hospital stays and lower costs, these differences were not statistically significant. The CBZ group reported significantly lower pain scores on postoperative days 2 and 7 (p < 0.05). Analgesic consumption was similar in the first 96 h postoperatively (p = 0.212), but significantly lower in the CBZ group from 96 h to discharge, particularly for opioids (p < 0.05).

CBZ effectively reduces postoperative pain, decreases analgesic use without increasing adverse effects in patients with tentorial meningiomas. These findings support the incorporation of CBZ into multimodal pain management strategies for this patient population.