Simon Éva, Csipkés Csaba, Andráskó Dániel, Kovács Veronika, Szabó-Maák Zoltán, Tankó Béla, Buchholcz Gyula, Fülesdi Béla, Molnár Csilla
Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
University Pharmacy, Clinical Centre, University of Debrecen, Debrecen, Hungary.
Transl Neurosci. 2023 Dec 16;14(1):20220323. doi: 10.1515/tnsci-2022-0323. eCollection 2023 Jan 1.
Headache attributed to craniotomy is an underestimated and under-treated condition. Previous studies confirmed the efficacy of preemptive analgesia with non-steroidal anti-inflammatory agents. The aim of the present work was to test the hypothesis of whether a single preoperatively administered dose of dexketoprofen (DEX) has the potency to decrease postcraniotomy headache (PCH) as compared to placebo (PL).
This is a single-centre, randomized, PL-controlled trial comparing the effect of a single oral dose of 25 mg DEX to PL on the intensity of PCH. Patients undergoing craniotomy were randomly allocated to DEX and PL groups. Patients rated their actual and worst daily pain using visual analogue scale (VAS) scores during intrahospital treatment (0-5 days) and 30 and 90 days postoperatively.
Two hundred patients were included. DEX decreased the worst daily pain intensity in the first 24 h only; the 5-days cumulative score of actual pain was 9.7 ± 7.9 cm for the DEX group and 12.6 ± 10.5 cm for the PL group, respectively ( = 0.03). This difference disappeared in the late, 30-, and 90-day follow-up period. No differences in VAS scores could be detected in supra- and infratentorial cases among the DEX and PL groups.
A single preoperative dose of 25 mg of DEX slightly decreases the intensity of PCH in the first 5 days after craniotomy but it does not have an effect on chronic headaches and postoperative analgesic requirements.
开颅术后头痛是一种未得到充分重视和治疗的疾病。既往研究证实非甾体类抗炎药进行超前镇痛的有效性。本研究的目的是验证与安慰剂(PL)相比,术前单次给予右酮洛芬(DEX)是否有降低开颅术后头痛(PCH)的作用。
这是一项单中心、随机、PL对照试验,比较单次口服25mg DEX与PL对PCH强度的影响。接受开颅手术的患者被随机分配至DEX组和PL组。患者在住院治疗期间(0 - 5天)以及术后30天和90天使用视觉模拟量表(VAS)评分对其每日实际疼痛和最严重疼痛进行评分。
纳入200例患者。DEX仅在最初24小时降低了每日最严重疼痛强度;DEX组实际疼痛的5天累计评分为9.7±7.9cm,PL组为12.6±10.5cm(P = 0.03)。在后期的30天和90天随访期,这种差异消失。DEX组和PL组幕上和幕下病例的VAS评分未检测到差异。
术前单次给予25mg DEX可在开颅术后的前5天轻微降低PCH的强度,但对慢性头痛和术后镇痛需求无影响。