ABSTRACT
In a review paper, an analysis of publications in the world literature on the problem of acute postoperative pain in neurosurgical patients who underwent craniotomy is performed. Is shown that problem of acute postoperative pain in patients after craniotomy was underestimated for a long time. Mistakenly was thought that these patients do not experience any pain in the early postoperative period. Results of recent studies have shown that up to 80% of these patients may experience acute pain in the range from mild to severe. Unarrested postoperative pain could cause a number of serious secondary complications. This article demonstrates basic approaches to the prevention and treatment of acute postoperative pain in neurosurgical patients after craniotomy--first of all, the use of narcotic analgesics, NSAIDs, and other approaches.
Subject(s)
Analgesia/methods , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Craniotomy , Narcotics/therapeutic use , Pain Management/methods , Postoperative Care/methods , Female , Humans , MaleABSTRACT
The goal of this study was to comparatively evaluate the efficacy of pre-emptive analgesia in patients after supra- and infratentorial craniotomy. Three hundred and sixty-two postcraniotomy patients aged 16 to 72 years were recruited in the study. The patients were divided into 5 groups. The first two groups received traditional analgesia on demand with metamizole sodium and ketoprofen (Group 1) or xefocam (Group 2). Groups 3-5 had different preemptive analgesia modes. Scheduled dosing of xefocam (8 mg i.v. 30 min prior to surgery and then 8 mg every 8 hours within 48 hours) was used in Group 3. Group 4 underwent scalp nerve block and skin infiltration with ropivacaine. Group 5 had a scheduled dosing of fentanyl (12-18 hours before surgery, Durogesic was applied to the patient's skin in a dose 25 microg per hour for 3 days). Postoperative pain was assessed using the visual analogue scale (VAS) at 6, 18, 30, 42, and 54 hours after surgery. The patients who received pre-emptive analgesia showed significantly lower VAS scores than those who had traditional analgesia (p < 0.05).
Subject(s)
Amides/therapeutic use , Analgesia/methods , Analgesics/therapeutic use , Craniotomy , Fentanyl/therapeutic use , Pain, Postoperative/prevention & control , Piroxicam/analogs & derivatives , Administration, Cutaneous , Adolescent , Adult , Aged , Amides/administration & dosage , Analgesics/administration & dosage , Delayed-Action Preparations , Fentanyl/administration & dosage , Humans , Injections, Intravenous , Middle Aged , Pain Measurement , Piroxicam/administration & dosage , Piroxicam/therapeutic use , Ropivacaine , Treatment Outcome , Young AdultABSTRACT
It has been shown by optical and spectral methods that ischemic preconditioning in ischemic insult induces a protective action on brain tissues, which is registered by an decrease in the damage to low-density lipoproteins after ischemic insult.
