Practice of Postoperative Pain Management in Neurosurgery

Acetaminophen and nonsteroidal anti-inflammatory analgesics are commonly used for postoperative pain management after neurosurgery（craniotomy）, but they often result in inadequate analgesia. Local infiltration anesthesia of the scalp and nerve blocks to the peripheral nerves distributed in the scalp（so-called scalp blocks）are classic methods that have been reported for more than 100 years. Still, they are being reevaluated as perioperative analgesia methods with the widespread use of awake craniotomy in recent years. The application of regional anesthesia to the scalp can reduce the requirement for intraoperative opioid analgesics and alleviate pain in the immediate postoperative pe-riod. At present, pain control measures are needed after the effects of local anesthetics have expired, so multimodal pain management methods should be considered.