• Aude Charvet, Baptiste Bouchier, Frédéric Dailler, and Thomas Ritzenthaler.
• Service de Réanimation Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France. aude.charvet@chu-lyon.fr.
• Neurocrit Care. 2023 Feb 1; 38 (1): 9159-15.

BackgroundA significant number of patients admitted for aneurysmal subarachnoid hemorrhage (aSAH) are active smokers and are at risk of developing nicotine withdrawal symptoms (e.g., cravings, irritability, insomnia, headaches, etc.). This study aimed to evaluate the use of nicotine replacement therapy (NRT) regarding headache severity and analgesics consumption.MethodsA retrospective study was conducted using prospectively collected data from 2014 to 2019 in the neurointensive care unit of the Hospices Civils in Lyon, France. We performed a propensity score matching analysis. The covariables used were age, sex, initial World Federation of Neurosurgical Societies score, Hijdra sum score, and factors associated with pain following aSAH (history of chronic pain, anxiety, or depression). Smokers received NRT through a transdermal device. The primary end point was headache control. Secondary end points were mean numerical pain rating scale score and analgesics consumption.ResultsOne hundred and fifty-five patients were included among 523 patients hospitalized for aSAH. Fifty-one patients underwent nicotine substitution and were matched to 51 unsubstituted patients. The headache control rate was not different between the two groups (43.1% vs. 31.4%, p = 0.736). The mean numeric pain rating scale score in the substituted group was 2.2 (1.1-3.5) and 2.4 (1.6-3.1) in the unsubstituted group (p = 0.533). The analgesics consumption (acetaminophen, tramadol, and morphine) was the same in the two groups.ConclusionsThe use of NRT in the acute phase of aSAH does not seem to have an impact on the intensity of headaches or analgesics consumption.© 2022. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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