Incidence, predictors, and impact of acute post-operative pain after cranial neurosurgery: A prospective cohort study

• Published in: Journal of neurosciences in rural practice 2023-10, Vol.14 (4), p.637-643, Article 637
• Main Authors: Sriganesh, Kamath, Kramer, Boris W, Wadhwa, Archisha, Akash, V S, Bharadwaj, Suparna, Rao, G S Umamaheswara, Steinbusch, Harry W M, Konar, Subhas K, Gopalakrishna, Kadarapura Nanjundaiah, Sathyaprabha, T N
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 0976-3147; 0976-3155
• DOI: 10.25259/JNRP_141_2023

Pain is common after craniotomy. Its incidence and predictors in developing nations are not adequately studied. We aimed to assess the incidence, predictors, and impact of acute post-operative pain after intracranial neurosurgeries. This prospective observational study was conducted in adult patients undergoing intracranial neurosurgeries. After patient consent, ethics committee approval, and study registration, we assessed the incidence of post-operative pain using numerical rating scale (NRS) score. Predictors and impact of pain on patient outcomes were also evaluated. A total of 497 patients were recruited during 10-month study period. Significant (4-10 NRS score) post-operative pain at any time-point during the first 3 days after intracranial neurosurgery was reported by 65.5% (307/469) of patients. Incidence of significant pain during the 1 post-operative h, on the 1 , 2 , and 3 post-operative days was 20% (78/391), 50% (209/418), 38% (152/401), and 24% (86/360), respectively. Higher pre-operative NRS score and pain during the 1 h post-operatively, predicted the occurrence of pain during the first 3 days after surgery, = 0.003 and < 0.001, respectively. Pain was significantly associated with poor sleep quality on the first 2 post-operative nights ( < 0.001). Patient satisfaction score was higher in patients with post-operative pain, = 0.002. Every two in three patients undergoing elective intracranial neurosurgery report significant pain at some point during the first 3 postoperative days. Pre-operative pain and pain during 1 post-operative h predict the occurrence of significant post-operative pain.