Abstract
Introduction: Recent reports have shown the efficacy in using scheduled non-narcotic analgesic regimens following cranial and spine neurosurgery.
Methods: We review our experience and the literature regarding the use of scheduled doses of alternating acetaminophen and ibuprofen following craniotomy for tumor biopsy or resection.
Results: From our institutional experience with 51 children, postoperative imaging identified nine patients (17.67%) had routine, post-operative blood in the resection cavity per both radiology and neurosurgical review. One patient had moderate postoperative bleeding in the tumor cavity (1.9%). No patient was symptomatic and no patient required a return to the operating room. Twenty-eight patients required postoperative morphine for breakthrough pain (54.9%), 21 of which received less than three doses (75.0%). Overall, 44 of 51 patients (86.3%) required no or minimal narcotic medication for pain. A literature review supports these observations.
Conclusions: A scheduled regimen of non-steroidal anti-inflammatory drugs given in alternating doses immediately after craniotomy for tumor biopsy or resection and throughout hospitalization does not appear to result in any significant post-operative hemorrhage. It appears that such a regimen may lessen the need for postoperative narcotics, as opioid use following surgery was minimal in 86% of our patients.
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Tubbs, R.S., Mortazavi, M.M., Cohen-Gadol, A.A. (2012). Pediatric Brain Tumor Biopsy or Resection: Use of Postoperative Nonnarcotic Analgesic Medication. In: Hayat, M. (eds) Pediatric Cancer, Volume 2. Pediatric Cancer, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2957-5_17
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