Clinical study of acute and chronic pain after temporal craniotomy

Abstract

Objective To investigate the correlation of chronic pain after surgery and acute pain within 48 h after temporal craniotomy. Methods One hundred and seventy-six patients who underwent surgery through temporal approach were divided into 3 groups and treated with morphine 30 mg (Group M, N = 57), tramadol 1000 mg (Group T, N = 60) and morphine 20 mg + flurbiprofen 200 mg (Group F, N = 59) by patient-controlled intravenous analgesia (PCIA). Postoperative acute pain (resting and movement) was evaluated by Visual Analogue Scale (VAS) at 4, 16, 24 and 48 h respectively. Chronic pain was measured by Short-Form McGill Pain Questionnaire (SF-MPQ) 3 months after surgery. The characteristics of acute and chronic pain, the relationship between them and analgesic effect of 3 kinds of analgesic drugs were analyzed. Results The differences of observed indicators including gender, age, weight and operating time, which might affect the degree of postoperative pain between before and after surgery were not statistically significant (P > 0.05). VAS scores at different time points within 48 h after surgery in each group decreased gradually. The VAS scores in group T (2.91 ± 1.64) was significantly higher than group M (2.19 ± 1.68) and group F (1.71 ± 1.17, P < 0.05). There was no significant difference in the incidence and severity of chronic pain among 3 groups (P > 0.05). The overall incidence rate of chronic pain was 71.02% (125/176), with moderate and severe pain in 15.91% (28/176). Chronic pain and acute postoperative pain severity were positively correlated (resting: rs = 0.171, P = 0.012; movement: rs = 0.190, P = 0.006). The difference of the acute pain (VAS) corresponding to SF-MPQ Ⅱ score > 0 and SF-MPQ Ⅱ score = 0 was statistically significant (P < 0.05). Conclusion The postoperative chronic pain following temporal craniotomy is related to acute pain within 48 h after operation. Effective treatment of early postoperative acute pain may reduce the incidence of chronic pain.