POSTOPERATIVE PAIN IN NEUROSURGERY - A PILOT-STUDY IN BRAIN SURGERY

THE INCIDENCE, MAGNITUDE, and duration of acute pain experienced by ne urosurgical patients after various brain operations are not precisely known, because of a lack of well-designed clinical and epidemiological studies. We assessed these important pain variables in 37 consecutive patients who underwent various brain neurosurgical procedures. Postop erative pain was more common than generally assumed (60%). In two-thir ds of the patients with postoperative pain, the intensity was moderate to severe. Pain most frequently occurred within the first 48 hours af ter surgery, but a significant number of patients endured pain for lon ger periods. Pain was predominantly superficial (86%), suggesting soma tic rather than visceral origin and possibly involving pericranial mus cles and soft tissues. Subtemporal and suboccipital surgical routes yi elded the highest incidence of postoperative pain. Age and sex were si gnificantly associated with the onset of pain, with female and younger patients reporting higher percentages of postoperative pain. Psycholo gical Minnesota Multiphasic Personality Inventory profiles of patients with and without pain significantly differed on the Hypochondriasis s cale, with patients without pain scoring unexpectedly higher than pati ents with pain. It is possible that hypochondriasis serves as a defens e mechanism against pain, at least in some patients. Results of this p ilot study indicate that postoperative pain after brain surgery is an important, although neglected, clinical problem, that deserves greater attention by surgical teams, to provide better and more appropriate t reatment.