인문학
사회과학
자연과학
공학
의약학
농수해양학
예술체육학
복합학
DBpia AI
AI 에이전트
AI 아이디어
AI 리더
AI 뷰어
Citeasy
크롬 서지관리 다운로드
개인구독
소속 기관이 없으신 경우, 개인 정기구독을 하시면 저렴하게
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지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록·키워드
Postoperative pain control in neurosurgical patients particularly after elective craniotomy remains clinically challenging due to the need for early neurological assessment and the adverse effects associated with opioid use. This study aimed to compare the efficacy and safety of an opioid-sparing multimodal analgesia (MMA) protocol versus a conventional opioid-based regimen for managing post-craniotomy pain. This prospective, randomized controlled trial was conducted over 12 months at Zagazig University Hospitals and included 60 adult patients (aged 18–65 years, American Society of Anesthesiologists )ASA( physical status I–II) scheduled for elective supratentorial craniotomy with planned postoperative intensive care unit (ICU) admission. Patients were randomly assigned in a 1:1 ratio to either a multimodal opioid-sparing analgesia group (Group M, n = 30) or a conventional opioid-based analgesia group (Group O, n = 30) using simple randomization. The MMA protocol included preoperative oral gabapentin, intraoperative dexmedetomidine infusion, a postoperative scalp block with bupivacaine, and scheduled intravenous (IV) acetaminophen and ketorolac. The opioid group received scheduled IV morphine according to institutional practice. The primary outcome was the Visual Analog Scale (VAS) score at 2 h postoperatively. Secondary outcomes included time to first rescue analgesia, total opioid consumption, sedation scores, oxygen saturation, postoperative nausea and vomiting (PONV), and patient satisfaction. VAS scores were significantly lower in Group M at 1, 2, and 4 h postoperatively (P = 0.046, 0.039, and 0.045, respectively). A highly significant difference in sedation scores was observed between the groups at 30 min, 1 h, and 4 h (P < 0.001). Additionally, Group M had a significantly lower frequency of vomiting (P = 0.034); however, excellent satisfaction scores were more frequently reported in Group O, despite the objectively superior analgesic and safety profile observed in Group M. In this randomized controlled trial, opioid-sparing MMA provided superior postoperative pain control after elective craniotomy, with fewer adverse effects compared to conventional opioid-based regimens. These results support the incorporation of MMA into standard postoperative protocols and align with the principles of Enhanced Recovery After Surgery (ERAS) in neurosurgical care. This trial is registered with ClinicalTrials.gov under the identifier NCT05474040, with the initial registration on 26 July 2022, and retrospective registration available at ClinicalTrials.gov.
인공지능 문자 인식 모델을 통해 추출된 텍스트로, 일부 오타나 오류가 포함될 수 있으나 지속적으로 개선 중입니다.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
오류를 발견하셨다면 해당 부분을 드래그한 후 ' 를 통해 신고해주세요.
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