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Post-craniotomy analgesia: current practices in British neurosurgical centres – a survey of post-craniotomy analgesic practices

Published online by Cambridge University Press:  11 May 2005

G. C. Roberts
G. C. Roberts
Affiliation:
University Hospital of Wales, B4 Neurosurgery, Cardiff, Wales, UK
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Extract

Summary

Background and 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.

Method: 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.

Keywords

PAIN, postoperative, craniotomyANALGESIA, patient-controlled, intramuscularANALGESICS, codeine, morphine
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 5 , May 2005 , pp. 328 - 332
Copyright
© 2005 European Society of Anaesthesiology

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