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Current Neurology and Neuroscience Reports

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01.10.2016 | Critical Care (SA Mayer, Section Editor)

Post-Craniotomy Pain Management: Beyond Opioids

verfasst von: Lauren K. Dunn, Bhiken I. Naik, Edward C. Nemergut, Marcel E. Durieux

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 10/2016

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Abstract

Craniotomy pain may be severe and is often undertreated. Pain management following craniotomy is a balancing act of achieving adequate analgesia but avoiding sedation, respiratory depression, hypercapnia, nausea and vomiting, and hypertension. Opioids are a first-line analgesic therapy; however, concern that opioid-related adverse effects (sedation, respiratory depression) may interfere with neurologic assessment and increase intracranial pressure has limited use of these drugs for intracranial surgery. Non-opioid analgesics avoid these effects and may be useful as part of a multimodal regimen for post-craniotomy pain. Regional scalp blocks, paracetamol, and non-steroidal anti-inflammatory drugs are beneficial in the early post-operative period. Recent studies suggest a role for novel analgesics: dexmedetomidine, gabapentinoids, and ketamine, though additional studies are necessary.

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Titel: Post-Craniotomy Pain Management: Beyond Opioids
verfasst von: Lauren K. Dunn
Bhiken I. Naik
Edward C. Nemergut
Marcel E. Durieux
Publikationsdatum: 01.10.2016
Verlag: Springer US
Erschienen in: Current Neurology and Neuroscience Reports / Ausgabe 10/2016
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI: https://doi.org/10.1007/s11910-016-0693-y

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