Post-craniotomy analgesia: current practices in British neurosurgical centres--a survey of post-craniotomy analgesic practices.
OBJECTIVE
An evaluation of post-craniotomy analgesia within the University Hospital of Wales Neurosurgical Unit, Cardiff, found that many patients were experiencing moderate to severe pain post-craniotomy. It was therefore decided to undertake a nationwide survey of analgesic practices in order to establish best practice guidelines and benchmark with other units.


METHODS
A postal questionnaire was sent to the senior nurse of every Neurosurgical Directorate within the UK inquiring about the current, standard analgesic practices for post-craniotomy patients in their unit.


RESULTS
Completed replies were received from 23 of the 33 centres (70%). Intramuscular (i.m.) codeine phosphate was found to be the principal first-line analgesic used post-craniotomy. Only three centres used morphine as the first-line analgesic and only one centre used patient controlled analgesia routinely. The majority of centres (82%) used balanced analgesia. Pain assessments were only carried out in 57% of centres and no centre used a validated pain assessment tool specifically for dysphasic patients.


CONCLUSIONS
Codeine phosphate continues to be the mainstay of post-craniotomy analgesia, however, it is proposed that patient controlled analgesia with morphine is an efficacious and safe alternative.
Roberts
G C
GC
University Hospital of Wales, B4 Neurosurgery, Cardiff, Wales, UK. Gemma.Roberts@bromor-tr.wales.nhs.uk
D000698:Analgesia / Q000379:methods* / Q000706:statistics & numerical data; D000700:Analgesics / Q000627:therapeutic use*; D019985:Benchmarking; D003399:Craniotomy; D019538:Health Care Surveys; D006801:Humans; D007325:Institutional Practice / Q000706:statistics & numerical data; D009493:Neurosurgery; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care / Q000379:methods* / Q000706:statistics & numerical data; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom
D000700:Analgesics