Safety and utility of scheduled nonnarcotic analgesic medications in children undergoing craniotomy for brain tumor

Neurosurgery
David F BauerW Jerry Oakes

Abstract

We have reported that a scheduled nonnarcotic analgesic regimen after dorsal lumbar rhizotomy and Chiari I malformation decompression is efficacious in managing postoperative pain in children. To date, this regimen has not been analyzed in children after brain tumor biopsy or resection. To elucidate the safety and utility of such an analgesic protocol in these patients. A database review was conducted to identify children who received a scheduled dose of alternating acetaminophen and ibuprofen after craniotomy for tumor biopsy or resection, and postoperative imaging was evaluated. Fifty-one children who met the inclusion criteria were identified. On postoperative imaging, 17.67% had routine, postoperative blood in the resection cavity according to both radiology and neurosurgical review. One patient had moderate postoperative bleeding in the tumor cavity. Overall, 44 of the 51 patients (86.3%) required no or minimal narcotic medication for pain. A scheduled regimen of nonsteroidal antiinflammatory drugs given in alternating doses immediately after craniotomy for tumor biopsy or resection and throughout hospitalization did not result in any significant postoperative hemorrhage in our patient series.

References

Jun 1, 1996·British Journal of Neurosurgery·N QuineyF Walters
Feb 9, 2000·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·A ChiarettiC Di Rocco
Mar 11, 2000·Anaesthesia·J M Cupitt
May 1, 1997·Indian Journal of Pediatrics·R A Berkowitz, T B McDonald
Apr 26, 2000·Anaesthesia·P Shirley
Mar 22, 2002·Journal of Neurosurgical Anesthesiology·Eric VerchèrePierre Maurette
Oct 14, 2006·Neurosurgery·Scott Y RahimiCargill H Alleyne
Apr 7, 2007·Journal of Neurosurgery·Allan GottschalkMyron Yaster
Jun 15, 2007·Journal of Neurosurgery·R Shane TubbsW Jerry Oakes
Sep 22, 2007·Anesthesiology Clinics·Jose Ortiz-Cardona, Audrée A Bendo

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