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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Craniotomy site influences postoperative pain following neurosurgical procedures: a retrospective study.
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Craniotomy site influences postoperative pain following neurosurgical procedures: a retrospective study.

机译：颅骨切开术部位会影响神经外科手术后的术后疼痛：一项回顾性研究。

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OBJECTIVE: This retrospective study was designed to assess the intensity of postoperative pain in relation to the location of craniotomy. METHODS: After Research Ethics Board approval, data were collected from the charts of all patients who underwent a craniotomy at our institution between January 2004 and December 2005. The severity of post-craniotomy pain was assessed by collecting scores obtained using an 11-point verbal rating scale and calculating the cumulative analgesic requirements for the first 48 hr postoperatively. Data were compared according to the craniotomy location. RESULTS: Data from 299 patients was available for analysis. On average, 76% of patients experienced moderate to severe postoperative pain. Frontal craniotomy was associated with lower pain scores than four of six craniotomy sites analyzed, with 49% of patients reporting mild pain, a significant difference (P < 0.05) compared with all other groups except for parietal craniotomies. Frontal craniotomy patients also had lower opioid analgesic requirements compared to patients who underwent posterior fossa craniotomy (P < 0.05). Logistic regression analysis showed that craniotomy location (P < 0.0001) and age (P = 0.004) were both independent predictors of the intensity of postoperative pain, with lower pain scores as age increased. Postoperative use of steroids, gender and presence of preoperative pain were not statistically linked to postoperative pain intensity. The prevalence of postoperative nausea and vomiting was 56% and it did not vary according to the location of craniotomy. CONCLUSION: This study shows that the intensity of postoperative pain in neurosurgery is affected by the site of craniotomy. Frontal craniotomy patients experienced the lowest pain scores, and required significantly less opioid than patients undergoing posterior fossa interventions.
机译：目的：这项回顾性研究旨在评估与开颅手术位置相关的术后疼痛强度。方法：在研究伦理委员会批准后，从我们机构在2004年1月至2005年12月间接受开颅手术的所有患者的图表中收集数据。通过收集11点口头语言获得的评分来评估开颅术后疼痛的严重程度评估量表并计算术后前48小时的累积镇痛要求。根据开颅手术位置比较数据。结果：299名患者的数据可供分析。平均而言，76％的患者术后出现中度至重度疼痛。额叶开颅手术的疼痛评分低于所分析的六个开颅手术部位中的四个，其中49％的患者报告轻度疼痛，除顶颅开颅手术外，与所有其他组相比，差异有统计学意义（P <0.05）。与进行后颅窝开颅手术的患者相比，额叶开颅手术患者的阿片类镇痛要求也较低（P <0.05）。 Logistic回归分析显示，开颅手术的位置（P <0.0001）和年龄（P = 0.004）都是术后疼痛强度的独立预测指标，并且随着年龄的增加疼痛评分降低。术后使用类固醇，性别和术前疼痛的发生与术后疼痛强度无统计学关系。术后恶心和呕吐的患病率为56％，并且根据开颅手术的位置没有变化。结论：这项研究表明，神经外科手术后疼痛的程度受开颅部位的影响。与进行后颅窝手术的患者相比，额叶开颅手术患者的疼痛评分最低，且阿片类药物的需要量明显减少。

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