Gender Difference in Early Pain After Craniotomy
Journal Title: Journal of Neurological Sciences-Turkish - Year 2012, Vol 29, Issue 2
Abstract
Objective (Background): The aim of this study was to determine the aetiology, quality and quantity of the pain following craniotomy during early postoperative period with using visual analogue score (VAS) and verbal rating scale (VRS). Methods: All craniotomy patients received 5 mg kg-1 Thiopental, 2 mcg kg-1 Fentanyl, 0,6 mg kg-1 rocuronium for induction of anesthesia, and 0,1- 2 mg kg hrs -1 propofol, 0,15-1,00 mcg. Kg-1 min-1 remifentanyl infusions with 50% oxygen-air mixture and additional doses of rocuronium (0,15 mg kg-1) for maintenance of anesthesia. Before craniotomy, scalp around incisional area was infiltrated with 20 ml local anesthetic (1% lidocaine with 35 mcg. mL-1 adrenaline). All patients' age, weight, height, gender and location of surgical incision (supratentorial or infratentorial), the cause (vascular or tumor) and the duration of the surgery was recorded. All patients' heart rate, systolic and diastolic blood pressure, Ramsay sedation status scale was assessed and reported at 0., 30th. and 60th. minutes after operation and during discharge time from post anesthesia care unit (PACU). Patients who were unconscious before or after surgery, with limited cooperation and impaired cognitive functions were excluded from the study. Results: In the early post-operative period, following craniotomy, the pain was mild to moderate according to VRS, and the pain was disturbing according to VAS scores of the patients. The average scores were 3.91± 2, 45 for VAS and 1.40 ± 1,08 for VRS at 0. minute of postoperative period. There was statistically significant decrease in VAS and VRS scores at 30. and 60. minutes. In women at 0. min and 1. hours VAS- VRS scores were higher than in men's VAS- VRS scores (p<0,05). Conclusions: We found that, there is mild to moderate pain following craniotomy. We conclude that, it is probably due to local anesthetic infiltration of surgical scalp area before surgical incision. We couldn't find any correlation or statistically significant relationship according to VAS and VRS with supratentorial or infratentorial surgical approaches, different surgical incisional style, vascular or tumoral pathology, ASA status of the patients, age range and duration of surgery. There was significant correlation only with gender and the early pain following craniotomy.
Authors and Affiliations
Arda CEYLAN, Abdurrahim DERBENT, Necati GOKMEN, Ozgun ANADOLU, Semra KARAMAN, Mehmet UYAR
Keywords
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