title: Postoperative analgesia for supratentorial craniotomy.
abstract: OBJECTIVE
  The prevalence of moderate to severe pain is high in patients following craniotomy. Although optimal analgesic therapy is mandatory, there is no consensus regarding analgesic regimen for post-craniotomy pain exists. This study aimed to investigate the effects of morphine and non-opioid analgesics on postcraniotomy pain.
  
  
  METHODS
  This prospective, randomized, double blind, placebo controlled study included eighty three patients (ASA 1, II, and III) scheduled for elective supratentorial craniotomy. Intravenous dexketoprofen, paracetamol and metamizol were investigated for their effects on pain intensity, morphine consumption and morphine related side effects during the first 24h following supratentorial craniotomy. Patients were treated with morphine based patient controlled analgesia (PCA) for 24h following surgery and randomized to receive supplemental IV dexketoprofen 50mg, paracetamol 1g, metamizol 1g or placebo. The primary endpoint was pain intensity, secondary endpoint was the effects on morphine consumption and related side effects.
  
  
  RESULTS
  When the whole study period was analyzed with repeated measures of ANOVA, the pain intensity, cumulative morphine consumption and related side effects were not different among the groups (p>0.05).
  
  
  CONCLUSIONS
  This study showed that the use of morphine based PCA prevented moderate to severe postoperative pain without causing any life threatening side effects in patients undergoing supratentorial craniotomy with a vigilant follow up during postoperative 24h. Although we could not demonstrate statistically significant effect of supplemental analgesics on morphine consumption, it was lower in dexketoprofen and metamizol groups than control group.
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: korkmazdilmen@gmail.com.
authors.forename: Ozlem Korkmaz
authors.initials: OK
authors.lastname: Dilmen
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: erenfat@yahoo.com.
authors.forename: Eren Fatma
authors.initials: EF
authors.lastname: Akcil
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: ytunali@yahoo.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Tunali
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: karabulut_esra@hotmail.com.
authors.forename: Esra Sultan
authors.initials: ES
authors.lastname: Karabulut
authors.affiliation: VKF, American Hospital, Department of General Intensive Care Unit, Turkey. Electronic address: bahar.mois@gmail.com.
authors.forename: Mois
authors.initials: M
authors.lastname: Bahar
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: fatisaltintas@hotmail.com.
authors.forename: Fatis
authors.initials: F
authors.lastname: Altindas
authors.affiliation: University of Istanbul, Cerrahpasa School of Medicine, Department of Biostatistics, Turkey. Electronic address: ertem@istanbul.edu.tr.
authors.forename: Hayriye
authors.initials: H
authors.lastname: Vehid
authors.affiliation: Istanbul Bilim University, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: eyentur@gmail.com.
authors.forename: Ercument
authors.initials: E
authors.lastname: Yentur
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003399:Craniotomy / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D009020:Morphine
keywords: Dexketoprofen; Metamizol; Paracetamol; Supratentorial craniotomy