title: Suboptimal pain treatment after craniotomy.
abstract: BACKGROUND
  Only few studies have investigated pain, nausea, sedation and analgesic strategies in post-craniotomy patients. The aim of this observational study was to explore pain, nausea, sedation and analgesic procedures after craniotomy, and to evaluate the quality of current analgesic therapy administered to post-craniotomy patients.
  
  
  METHODS
  A total of 59 patients undergoing supratentorial or infratentorial craniotomy were included over a three-month period. The intensity of pain, nausea and sedation was evaluated at 1, 2, 4, 8 and 24 h after extubation. Post-operative analgesic consumption at 0-48 h after extubation was noted. Post-operative morphine consumption in relation to gender, surgical procedure, administration of preoperative steroids and application of surgical drains was evaluated.
  
  
  RESULTS
  Fifty patients completed the study. After the first post-operative hour, 56% suffered from moderate-to-severe pain, which decreased to 38% at 24 h post-operatively. Patients receiving preoperative steroids experienced significantly less pain than patients who did not receive preoperative steroids (p = 0.04). The mean post-operative morphine consumption 0-48 h post-operatively was 28.8 mg (± 23.6 mg). Only 52% of the patients received the planned amount of acetaminophen of 4,000 mg/day.
  
  
  CONCLUSIONS
  Pain following craniotomy is moderate to severe in a substantial number of patients. The quality of the analgesic treatment leaves room for improvement. Administration of preoperative steroids may reduce post-craniotomy pain.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Anaestesiologisk Klinik 4231, HovedOrtoCentret, Rigshospitalet, 2100 Copenhagen, Denmark. morten_sejer@yahoo.dk
authors: Morten Sejer
authors: MS
authors: Hansen
authors: Jannick
authors: J
authors: Brennum
authors: Finn Borgbjerg
authors: FB
authors: Moltke
authors: Jørgen Berg
authors: JB
authors: Dahl
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009325:Nausea / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011300:Preoperative Care; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D013256:Steroids; D000082:Acetaminophen; D009020:Morphine