title: Post-operative analgesia for craniotomy patients: current attitudes among neuroanaesthetists.
abstract: As part of an evaluation of post-operative analgesia for craniotomy patients, a postal questionnaire was sent to 183 consultant members of the Neuroanaesthesia Society of Great Britain and Ireland, inquiring about their current practices for post-operative neurosurgical analgesia. Replies were received from 110 neuroanaesthetists in 37 different neurosurgical centres. Intramuscular codeine phosphate or dihydrocodeine was the mainstay of post-operative analgesia for 97% of neuroanaesthetists despite the fact that over half of them thought that analgesia was inadequate. Only four neuroanaesthetists would ever consider using opioids post-operatively because of fears about respiratory depression and sedation, yet all except one used opioids per-operatively. Post-operative analgesia for craniotomy patients is perceived as inadequate by most neuroanaesthetists, yet traditional prejudice against opioid use prevents this being remedied. We suggest that patient-controlled analgesia with morphine could be a safe alternative to codeine phosphate.
authors.affiliation: Department of Anaesthesia, Frenchay Hospital, Bristol, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Stoneham
authors.forename: F J
authors.initials: FJ
authors.lastname: Walters
mesh_terms: D000698:Analgesia; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000776:Anesthesiology; D001291:Attitude of Health Personnel; D003061:Codeine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003399:Craniotomy / Q000009:adverse effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007273:Injections, Intramuscular; D007430:Intraoperative Care; D007494:Ireland; D009020:Morphine / Q000008:administration & dosage; D009493:Neurosurgery; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D011287:Prejudice; D012119:Respiration / Q000187:drug effects; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009020:Morphine; C014481:dihydrocodeine; D003061:Codeine