Yaster M

Language: English
References: 14
Page: 232-233
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Historically, the pain associated with intracranial surgery has been under-treated because of the fear that the use of opioids may interfere with the post-operative neurologic examination or lead to its deterioration. Much of the information concerning the quality, duration, and treatment of pain following cranial surgery was until recently anecdotal. Opioids, the analgesics most often prescribed for moderate to severe acute post-operative pain were rarely used because of the fear that they may produce sedation and miosis and mask signs of intracranial catastrophe. Furthermore, opioids, even when administered in therapeutic doses, may depress minute ventilation leading to hypercapnia, increased intracerebral blood volume, and potentially increased intracranial pressure and cerebral edema. Moreover, why expose a patient to these risks when there is a presumed lack of need? Decades of training and anecdote have reinforced a widely held belief that patients do not experience intense pain following intracranial surgery, a belief supported by the fact that surgery on the brain parenchyma per se is not painful.

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