Early postoperative complications following neurosurgical proceduresPurpose: To assess the incidence and characteristics of early postoperative complications in patients following neurosurgical procedures. Methods: All patients undergoing neurosurgery during a four month period were followed postoperatively for up to four hours in the post anesthetic care unit or intensive care unit. Patient information and all complications were documented by the investigators on a standardized form. Complications were classified as respiratory, cardiovascular, nausea and vomiting, shivering and other. Risk factors analyzed for the occurrence of complications included age, sex, ASA status, type of surgery, elective or emergency surgery and postoperative placement. Results: Four hundred eighty six adult patients were followed, but in 55 patients the trachea remained intubated during the four hour study period and they were eliminated from the analysis of postoperative complications. At least one complication occurred in 54.5% of the remaining 431 patients. Respiratory problems occurred in 2.8%, trauma to the airway in 4.4%, cardiovascular complications in 6.7%, neurological in 5.7% and nausea and/or vomiting in 38%. The highest incidence of patients with complications was during spine (65%) and vascular (66%) surgery, compared with tumour (47%) and other (43%) surgery, P < 0.05. Other risk factors included age < 70 yr for nausea and vomiting (P < 0.02), and elective surgery for spine and vascular surgery (P < 0.001 ). Conclusion: There was a high incidence of early postoperative complications in neurosurgical patients. The most common problem was nausea and vomiting especially in the younger patient undergoing elective spine surgery.Objecdf: I~valuer les caract&istiques et I'incidence de complications postop&atoires pr&oces chez des patients qui ont subi une intervention neurochirurgicale. M~.thode : Pendant quatre mois, tousles patients qui avaient subi une neurochirurgie ont &~ suivis, pendant une p&iode pouvant aller jusqu'~, quatre heures, ~ la salle de r6veil ou ~ I'unit~ des soins intensifs. Les chercheurs ont not~ sur un formulaire standardis6 les informations recueillies aupr& du patient et routes les complications. Ces derni&es ont Et6 class~es en complications respiratoires, cardiovasculaires, nausEes et vomissements, frissons et autres. Les facteurs de risques analys~s selon la survenue des complications comprenaient I'~ge, le sexe, 1'6tat ASA, le type de chirurgie, I'aspect prEvisible ou non de la chirurgie et le placement postop6ratoire. REsultats 9 Quatre cent quatre-vingt six patients adultes ont &6 suivis, mais on a exclu 55 patients de I'analyse des complications postop&atoires puisqu'ils ont eu besoin d'intubation pendant les quatre heures de I'exp&ience. Une complication au moins est survenue chez 54,5 % des 431 autres patients. Des complications respiratoires sont survenues chez 2,8 % des patients, cardiovasculaires chez 6,7 %, neurologiques chez 5,7 %; un traumatisme des voies a&iennes chez 4,4 % et des naus...

This is the first study comparing the use of desflurane and TIVA showing that both anesthetic regimens allowed successful intraoperative monitoring useage throughout the procedures. For MEP recording, the AH was the preferred muscle with a desflurane anesthetic regimen.

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This combination of anesthetic and stimulation protocols is efficacious for IOM during spinal cord surgery. Our findings support the use of desflurane for successful acquisition of MEPs during scoliois surgery as an alternative anesthetic regime.