Postoperative Pain Trajectories After Craniotomy in Brain Tumor Patients: A Cross-Sectional Study of Intensity and Characteristics

Background and Objectives: Post-craniotomy pain is common in brain tumor patients, yet the day-to-day course and qualitative features during the first postoperative days are insufficiently described; prior reports often mix heterogeneous surgical indications or focus only on the immediate PACU period or long-term headache. We aimed to address this gap by quantifying early postoperative pain trajectories and characterizing pain quality and timing in a homogeneous brain-tumor cohort. Materials and Methods: In this cross-sectional study of 100 adults after craniotomy, pain intensity (0–10 NRS) and pain characteristics were assessed on postoperative days (POD) 2–4 using a structured questionnaire; subgroup analyses compared first-time vs. previously operated patients. Results: Median NRS decreased from 2.00 on POD2 to 0.00 on POD4 (Friedman p < 0.001). Pulsatile pain was most frequent (≈46% on POD2), while higher intensities were uncommon by POD4; no significant differences were observed between first-time and previously operated patients. Conclusions: These findings fill a short-term evidence gap by delineating early pain trajectories and descriptors specific to brain-tumor craniotomy and support pragmatic, individualized analgesia in the first postoperative days. Future studies should complement NRS with multidimensional outcomes to capture affective and functional aspects of pain.