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Introduction: Headache in neurosurgical patients is an important clinical problem that has been receiving an increasing amount of attention. However, only a few studies have described cases of headache following craniotomy, and even fewer have proposed pain management for this pathology. In contrast, general postoperative pain has been extensively studied, and there are thus many guidelines to treat such pain. Here we propose a regimen that includes the use of analgesics based on postoperative pain guidelines.

Material and Methods: A randomized prospective study was performed on all neurosurgical patients who had underwent craniotomy at the National Institute of Neurology and Neurosurgery between September 2016 and September 2017. The subjects were subdivided into control and experimental groups. Each group comprised 50 patients. Analgesic management in the experimental group was based on multimodal analgesia.

Results and Discussion: There was a significant difference in the Analogue Visual Scale scores between the control and experimental groups, both on the last hospitalization day (p = 0.000) and at the 6-month follow-up (p = 0.002). There was thus a significant amelioration of pain among patients in the experimental group when compared to those in the control group.

Adequate preoperative and follow up pain management is of most importance for patient care and outcome.Our findings indicate that there was a decrease in pain following multimodal analgesia in post-craniotomy patients

Conclusion: Based on the results obtained in this study and the previously reported evidence, we suggest that postoperative management of acute and persistent headache in patients who undergo craniotomy should comprise multimodal analgesia.