Please select the eligibility criteria that correspond to the clinical trial below.
Title: Comparison of Efficacy and Safety of the Postoperative Analgesia Methods for Supratentorial Craniotomy by Integrated Pulmonary Index (IPI)
Brief Summary: An optimal analgesic therapy is very important for postoperative recovery. In recent years, several studies showed that the prevalence of the moderate to severe pain after craniotomy ranged from 69 to 87% of patients. In a previous study, the investigators showed that the use of morphine based patient controlled analgesia prevented moderate to severe postoperative pain in patients undergoing supratentorial craniotomy. Morphine related side effects such as sedation, miosis, respiratory depression, nausea and vomiting produce a general reluctance for their use in neurosurgery. Therefore, all patients were closely observed to detect opioid related side effects in the intensive care unit for 24 hours following surgery in the previous study. The Integrated Pulmonary Index (IPI) is a new tool that calculates respiratory and hemodynamic parameters noninvasively. In the present study the investigators will use different doses of morphine based PCA and the IPI system to determine more effective and safer morphine dose for postoperative analgesia following supratentorial craniotomy.


Options:
A: Inclusion Criteria:

* Adult patient undergoing ENTS surgery for resection of pituitary tumor.
* Adults \>18 years and \<80 years of age.
* English speaking and literate or able to understand the use of a pain scale.
* Body Mass Index \>19 and \<40 kg/m2

Exclusion Criteria:

* Renal failure (acute or chronic) or creatinine \>2.0
* Allergy or intolerance to acetaminophen, ibuprofen, or opioids
* Pre-operative opioid tolerance, dependence, or abuse
* Anaphylaxis to opioids
* History of peptic ulcer disease or recent gastrointestinal bleed requiring surgery
* Cirrhosis, hepatitis, liver transplant, or liver function studies out of normal range, defined as aspartate aminotransferase (AST)/alanine aminotransferase (ALT)/bilirubin\> 3x upper limit of normal range
* Subject unwilling or unable to sign informed consent for the study
* Pregnancy
* Incarcerated patients
B: Inclusion Criteria:

1. ASA Ι and II.
2. Both males and females, age (18-60) years.
3. Supine position.
4. Glasco coma scale more than 12.
5. Elective craniotomy operations.

Exclusion Criteria:

1. ASA ΙII or IV
2. History of allergy to the study drugs.
3. Surgery to remove pituitary tumours or affecting pituitary hormones.
4. Glasco coma scale less than 12.
5. The need for postoperative ventilation.
C: Inclusion Criteria:

* ASA (American Society of Anesthesiologists) physical status I-III
* patients who will undergo intracranial surgery under general anesthesia only
* Patients undergoing awake-technique procedures will also be enrolled.

Exclusion Criteria:

* allergy to opioids, midazolam, PGL, or non-steroidal anti-inflammatory drugs (NSAIDs), dipyrone
* history of chronic pain or psychiatric disorders and the use of centrally acting antidepressant and antipsychotic drugs. Patients longtime users of sedatives, or antiepileptics
* soldiers and pregnant women
* Emergency cases, DBS procedures and patients unable to comprehend and sign the consent form
D: Inclusion Criteria:

* Diagnosis of supratentorial neoplasms

Exclusion Criteria:

* Neurological disorders hindering the communication, aphasia, Glasgow Coma Score (GCS) less than 15, drug or alcohol addiction, chronic pain, raised intracranial pressure, allergies to any of the drugs used in this study, hepatic or renal dysfunction, peptic ulcer disease, dementia.

Answer: D