Perspectives on Analgesia for Craniotomy: A Survey of Anesthetic Practices
6
Issued Date
2025-01-01
Resource Type
ISSN
08984921
eISSN
15371921
Scopus ID
2-s2.0-105002428767
Journal Title
Journal of Neurosurgical Anesthesiology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Neurosurgical Anesthesiology (2025)
Suggested Citation
Vincent A., Burbridge M.A., Chaikittisilpa N., Chakraborty I., Chong M., Chowdhury T., Garcia P., Gaudet J.G., Kiatchai T., Prabhakar H., Shiferaw A.A., Shrestha G.S., Tan P.C.S., Tavares C., Vacas S., Blacker S.N., Lele A.V., Mejia-Mantilla J. Perspectives on Analgesia for Craniotomy: A Survey of Anesthetic Practices. Journal of Neurosurgical Anesthesiology (2025). doi:10.1097/ANA.0000000000001033 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/109629
Title
Perspectives on Analgesia for Craniotomy: A Survey of Anesthetic Practices
Author's Affiliation
Siriraj Hospital
Fundación Valle del Lili
Tribhuvan University Teaching Hospital
Addis Ababa University
Stanford University School of Medicine
Columbia University
The George Washington University School of Medicine and Health Sciences
University of Arkansas for Medical Sciences
Centre Hospitalier Universitaire Vaudois
UNC School of Medicine
All India Institute of Medical Sciences, New Delhi
Sarawak General Hospital
Universidade de São Paulo
Harvard Medical School
Toronto Western Hospital
St. Vincent's Hospital Melbourne
Harborview Medical Center
Fundación Valle del Lili
Tribhuvan University Teaching Hospital
Addis Ababa University
Stanford University School of Medicine
Columbia University
The George Washington University School of Medicine and Health Sciences
University of Arkansas for Medical Sciences
Centre Hospitalier Universitaire Vaudois
UNC School of Medicine
All India Institute of Medical Sciences, New Delhi
Sarawak General Hospital
Universidade de São Paulo
Harvard Medical School
Toronto Western Hospital
St. Vincent's Hospital Melbourne
Harborview Medical Center
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: This study aimed to compare analgesic practices for patients undergoing craniotomy in high-income countries (HICs) and low-income and middle-income countries (LMICs), focusing on variations in medication use and techniques. Methods: An English-language and Spanish-language electronic survey was sent to over 300 anesthesiologists in 35 countries from March 22 to May 19, 2024, to gather data on analgesia for craniotomy patients. Anonymous responses through REDCap were analyzed as a whole and by income category (HICs and LMICs). Results: We received 328 responses (105 HICs, 221 LMICs, and 2 missing locations). Acetaminophen was used by 78% of respondents (HIC: 82%, LMIC: 76%), with low nonavailability in both groups (0.95% HICs, 4.98% LMICs). Fentanyl boluses were used in 57% of cases (HIC: 60%, LMIC: 55%). Incisional local anesthesia was administered in 51% (HIC: 52%, LMIC: 50%), with minimal nonavailability (1.9% HIC, 1.4% LMIC). The use of a remifentanil infusion was more common in HICs (64%) than LMICs (31%), where nonavailability was significantly higher (43.89% vs. 7.62% HICs). Scalp blocks were used by 15% of HICs and 43% of LMICs. Craniotomy indication influenced the choice of analgesia for 61% of respondents. Conclusions: Analgesic practices for craniotomy vary significantly between HICs and LMICs, primarily due to medication availability. Global guidelines should consider resource differences to improve postoperative pain management.