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开颅术后头痛:病因与治疗。

Postcraniotomy Headache: Etiologies and Treatments.

机构信息

Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University, Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.

Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.

出版信息

Curr Pain Headache Rep. 2022 May;26(5):357-364. doi: 10.1007/s11916-022-01036-8. Epub 2022 Mar 1.

Abstract

PURPOSE OF REVIEW

Postcraniotomy headache (PCH) is a highly underappreciated and very common adverse event following craniotomy.

RECENT FINDINGS

Analgetic medication with opioids often interferes with neurologic evaluation in the acute phase of recovery and should be kept to a minimal, in general, in the treatment of chronic pain as well. We provide an update on the latest evidence for the management of acute and chronic PCH. Especially in the neurosurgical setting, enhanced recovery after surgery protocols need to include a special focus on pain control. Patients at risk of developing chronic pain must be identified and treated as early as possible.

摘要

目的综述

开颅术后头痛(PCH)是开颅术后一种极易被低估但非常常见的不良事件。

最新发现

阿片类镇痛药通常会影响术后恢复期的神经评估,因此在急性疼痛期应尽量少用,在慢性疼痛的治疗中也应尽量少用。我们提供了最新的急性和慢性 PCH 管理证据更新。特别是在神经外科环境中,术后恢复方案需要特别关注疼痛控制。必须尽早识别和治疗有发生慢性疼痛风险的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/619d/9061675/15eba2f79d7f/11916_2022_1036_Fig1_HTML.jpg

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