Postoperative pain management in craniotomy patients is notoriously difficult—balancing effective analgesia with the need for early neurological evaluation often leaves anesthesiologists defaulting to opioids, despite their drawbacks. This randomized, double-blind, placebo-controlled trial of 60 patients compared an opioid-sparing multimodal regimen (gabapentin, dexmedetomidine, scalp block, acetaminophen, ketorolac) against conventional IV morphine. The multimodal group achieved significantly lower VAS scores in the early postoperative period, less sedation, and reduced vomiting.
Interestingly, while satisfaction scores skewed higher in the opioid group, the objective safety and analgesic profile favored the multimodal approach—challenging traditional neuroanesthesia practices. To read the full trial in BMC Anesthesiology, click here . Are we ready to replace morphine-based…
