This study aims to manage the physical processes of incision, traction, and hemostasis used for a craniotomy to stimulate nerve fibers and specific nociceptors, resulting in postoperative pain. During the first 24 h after craniotomy, 87% of patients have postoperative pain. The rate of suffering pain after craniotomy falls 3% for every year of life. This study aims to review the available therapeutic options to help physicians treat this pain and discuss pain mechanisms, pathophysiology, plasticity, risk factors, and psychological factors. This is a narrative review of the literature from 1970 to June 2019. The researchers collected data by searching PubMed, EMBASE, Cochrane Reviews, and a manual search of all relevant literature references. The literature includes some drugs treatment: Opioids, codeine, morphine, and tramadol, anti-inflammatory non-steroid such as cyclooxygenase-2 inhibitors, gabapentin. It discusses side effects, pharmacodynamics, and indications of each drug, anatomy, and Innervation of Skull and its Linigs, the pathogenesis of pain Post-craniotomy, scalp nerve block, surgical nerve injury, neuronal plasticity, surgical factors, and chronic post-surgical pain.

The researchers are finding some more ways to manage acute pain during neurosurgery. They are taking all the cases to study them thoroughly to find something new from that.