To determine the differences between experience of post-operative pain after craniotomy in emergency versus elective cases.

Article Information

Title: To determine the differences between experience of post-operative pain after craniotomy in emergency versus elective cases.

Authors: Asim Rehmani, Mohammed Faiq Ali, Ramesh Kumar, Qazi Muhammed Zeeshan, Syed Muneeb Younus, Shiraz Ahmed Gauri

Journal: The Professional Medical Journal (TPMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2021-07-01	2022-06-30

Publisher: Independent Medical College, Faisalabad- Pakistan

Country: Pakistan

Year: 2022

Volume: 29

Issue: 8

Language: English

DOI: 10.29309/TPMJ/2022.29.08.6368

Keywords: Pain managementOpioidsCraniotomyPost operative painVisual analog scale

Abstract

Objective: To determine the differences in post-operative pain experienced by patients undergoing emergency versus elective craniotomies. Study Design: Cross-sectional study. Setting: General Hospital, Karachi. Period: January 2017 to December 2019. Material &amp; Methods: We included all the patients who underwent craniotomy at our institute and we measured their pain assessment levels. Further we excluded patients whose data was missing any variable of interest or whose measurements could not be taken at the time they were admitted to the hospital. All the data was analyzed using SPSS statistical software. Results: We included 152 patients in our study population. The mean age of the patients in our study group was 50 years of age and there were 81 males and 71 females included in our study. The combined pain scores for patients undergoing elective and emergency procedures was found to be 5.5 (Standard deviation= 2.6 for day one, 4.8 (Standard deviation= 2.6) for day two and 4.5 (Standard deviation=2.9) for day three post-operation respectively. When analysis was done to compare the differences in the VAS score for patients of the two categories we found no significant difference between the groups for day one having a p value of 0.485, for day two there was no significant difference as well having a p value of 0.957. Conclusion: We did not find any statistical difference in the two groups under study. The postoperative pain experience was similar in patients who underwent elective as compared to emergency craniotomies.

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Research Objective

To determine the difference between the experience of post-operative pain after craniotomy in emergency versus elective cases.

Methodology

Retrospective cross-sectional study conducted at a single tertiary care center in Karachi, Pakistan, from January 2017 to December 2019. Data was collected from health records of patients who underwent craniotomy. Pain assessment was measured using the Visual Analog Scale (VAS) for the first three days post-surgery. Data was analyzed using IBM SPSS 20 software.

Methodology Flowchart

                        graph TD;
    A["Data Collection from Health Records"] --> B["Patient Inclusion/Exclusion"];
    B --> C["Pain Assessment using VAS"];
    C --> D["Data Analysis using SPSS"];
    D --> E["Comparison of Emergency vs. Elective Groups"];
    E --> F["Conclusion on Pain Differences"];

Discussion

The study found no significant difference in post-operative pain experience between emergency and elective craniotomy patients. Potential confounding factors include the disproportionate number of patients in each group, the use of scalp nerve blocks, and the subjective nature of pain perception. The risks associated with opioid use, such as masking neurological signs, are acknowledged.

Key Findings

A total of 152 patients were included in the study. The mean age was 50 years, with 81 males and 71 females. The combined VAS pain scores were 5.5 (SD=2.6) on day one, 4.8 (SD=2.6) on day two, and 4.5 (SD=2.9) on day three post-operation. No statistically significant difference in VAS scores was found between emergency and elective craniotomy groups on day one (p=0.485) and day two (p=0.957). Data for day three was insufficient for analysis. Approximately 94.73% of patients received opioids for pain control.

Conclusion

The postoperative pain experience was similar in patients who underwent elective as compared to emergency craniotomies. Adequate pain management is crucial, but balancing its benefits against the risks of analgesics, particularly opioids, remains a challenge for neurosurgeons.

Fact Check

1. Study Period: The study was conducted from January 2017 to December 2019. (Confirmed in text)
2. Sample Size: 152 patients were included in the study population. (Confirmed in text)
3. Pain Score Day 1: The mean VAS pain score for day one post-operation was 5.5. (Confirmed in text)

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