Early postoperative complications following neurosurgical procedures

Abstract

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...

Rosiglitazone, a PPAR gamma agonist, attenuates inflammation after surgical brain injury in rodents

“…Previous studies have elucidated that oxidative stress, disruption of BBB and brain edema are critical in the pathophysiology of SBI , Lo et al, 2007. BBB disruption and brain edema are common complications after SBI which can lead to deteriorating neurological outcomes (Fasano and Penna 1992;Manninen et al 1999;Tommasino 1992). Inflammation has been reported to play a role in the development of vasogenic brain edema ) which occurs as a result of BBB disruption.…”

Neuroprotection against surgically induced brain injury

“…Even with adjunct treatments, the standard neurosurgical maneuvers, whether planned or performed in an emergency can cause damage to the surrounding brain tissue and may contribute to or result in critical early postoperative complications such as brain edema and ischemia or delayed healing [11,28,41]. Even if there are no life threatening and serious complications in most cases, neurosurgical patients have to be monitored closely, especially in the intensive care unit.…”

Anesthesiologic Management for Awake Craniotomy

“…Manninen indicates a comprehensive incidence of 38% with a predominance in younger compared to adult patients 28 . The frequency of PONV seems to be lower in patients submitted to awake craniotomy compared to those submitted to craniotomy under general anaesthesia.…”