Integrative review: postcraniotomy pain in the brain tumour patient.

Abstract:

AIM:To conduct an integrative review to examine evidence of pain and associated symptoms in adult (≥21 years of age), postcraniotomy, brain tumour patients hospitalized on intensive care units. BACKGROUND:Healthcare providers believe craniotomies are less painful than other surgical procedures. Understanding how postcraniotomy pain unfolds over time will help inform patient care and aid in future research and policy development. DESIGN:Systematic literature search to identify relevant literature. Information abstracted using the Theory of Unpleasant Symptoms' concepts of influencing factors, symptom clusters and patient performance. Inclusion criteria were indexed, peer-reviewed, full-length, English-language articles. Keywords were 'traumatic brain injury', 'pain, post-operative', 'brain injuries', 'postoperative pain', 'craniotomy', 'decompressive craniectomy' and 'trephining'. DATA SOURCES:Medline, OVID, PubMed and CINAHL databases from 2000-2014. REVIEW METHOD:Cooper's five-stage integrative review method was used to assess and synthesize literature. RESULTS:The search yielded 115 manuscripts, with 26 meeting inclusion criteria. Most studies were randomized, controlled trials conducted outside of the United States. All tested pharmacological pain interventions. Postcraniotomy brain tumour pain was well-documented and associated with nausea, vomiting and changes in blood pressure, and it impacted the patient's length of hospital stay, but there was no consensus for how best to treat such pain. CONCLUSION:The Theory of Unpleasant Symptoms provided structure to the search. Postcraniotomy pain is experienced by patients, but associated symptoms and impact on patient performance remain poorly understood. Further research is needed to improve understanding and management of postcraniotomy pain in this population.

journal_name

J Adv Nurs

authors

Guilkey RE,Von Ah D,Carpenter JS,Stone C,Draucker CB

doi

10.1111/jan.12890

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

1221-35

issue

6

eissn

0309-2402

issn

1365-2648

journal_volume

72

pub_type

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