Información del artículo
Resumen
El objetivo de esta revisión narrativa es confirmar si el dolor agudo tras craneotomía es frecuente y presenta una intensidad entre moderada-severa. Además, pretende informar de la importancia de tratar no solo el dolor tras craneotomía, sino prevenirlo para disminuir la incidencia de la cronificación del dolor. Debemos conocer que entre las opciones actuales no solo disponemos de los analgésicos convencionales para el postoperatorio (antiinflamatorios no esteroideos, paracetamol, inhibidores de la ciclooxigenasa 2 y opiáceos). La realización de un bloqueo nervioso del cuero cabelludo previo a la incisión quirúrgica o tras la cirugía, el uso de dexmedetomidina intraoperatoria y la administración perioperatoria de pregabalina son alternativas que están ganando fuerza. El manejo del dolor poscraneotomía debe basarse, por tanto, en una analgesia multimodal durante todo el perioperatorio, enmarcándose dentro del concepto actual del protocolo enhaced recovery after surgery.
Palabras clave:
Craneotomía
Dolor postoperatorio
Neurocirugía
Abstract
The aim of this narrative review is to confirm that acute pain after craniotomy is frequent and presents with moderate to severe intensity. We also highlight the importance of not only treating post-craniotomy pain, but also of preventing it in order to reduce the incidence of chronic pain. Physicians should be aware that conventional postoperative analgesics (non-steroidal anti-inflammatory, paracetamol, cyclooxygenase inhibitors 2, opioids) are not the only options available. Performing a scalp block prior to surgical incision or after surgery, the use of intraoperative dexmedetomidine, and the perioperative administration of pregabalin are just some alternatives that are gaining ground. The management of post-craniotomy pain should be based on perioperative multimodal analgesia in the framework of an “enhaced recovery after surgery” (ERAS) approach.
Keywords:
Craniotomy
Postoperative pain
Neurosurgery
Artículo
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