Pain management after craniotomy

Historically, the pain associated with intracranial surgery has been undertreated because of a presumed lack of need and a fear that the use of opioids could interfere with the neurologic examination or lead to its deterioration. Much of the information concerning the quality, duration, and treatment of pain after craniotomy surgery is anecdotal. We discuss the conundrum that clinicians face in treating these patients, common myths, impediments to care, and commonly used analgesics in postoperative pain. Finally, recommendations based on our current practice are made about analgesic therapy and future research directions.