Incidence and predicting factors of perioperative complications during monitored anesthesia care for awake craniotomy

Abaziou, Timothée; Tincres, Francis; Mrozek, Ségolène; Brauge, David; Marhar, Fouad; Delamarre, Louis; Menut, Rémi; Larcher, Claire; Osinski, Diane; Cinotti, Raphaël; Sol, Jean‐Christophe; Fourcade, Olivier; Roux, Franck‐Emmanuel; Geeraerts, Thomas

doi:10.1016/j.jclinane.2020.109811

Cited by 18 publications

(8 citation statements)

References 25 publications

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“…Moreover, it can inhibit throat reflex to some extent and effectively reduce postoperative adverse reactions such as intraoperative nausea, vomiting, and irritability [16,17]. So the two drugs used in combination can not only achieve relatively fast and stable intraoperative anesthetic effect, and the combination of propofol use can reduce the dosage of fentanyl, thereby reducing respiratory effects produced by rui fentanyl, and inhibition of intraoperatie injury stimulation, thus maintaining intraoperative hemodynamic stability, consistent with the findings [18]. In addition, OAA/S score was also used to compare the sedation degree of patients in the two groups during awakening.…”

Section: Related Worksupporting

confidence: 81%

The Efficacy of Remifentanil Combined with Propofol in Craniotomy for Tumor Was Evaluated by Wake Quality, Hemodynamics, and Adverse Reactions

Zhou

Han

Chen

2022

BioMed Research International

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In order to investigate the effect of remifentanil combined with propofol on awakening of craniotomy for tumor, a retrospective analysis is conducted. 86 patients who underwent craniotomy for brain tumor in our hospital from July 2020 to December 2021 are chosen to observe the quality of awakening, hemodynamic parameters, and the occurrence of adverse reactions. All patients are divided into group A ( n = 43 ) and group B ( n = 43 ) according to the use of anesthesia drugs. The intraoperative awakening quality and the hemodynamic parameters during different periods of the two groups are compared. The experimental results show that the incidence of postoperative adverse reactions in group B is significantly lower than that in group A ( P < 0.05 ). It is clearly evident that remifentanil combined with protocol has good intraoperative wake-up effect in craniotomy for tumor and maintain the hemodynamic stability of patients. Also, it can obtain high wake-up quality and effectively reduce postoperative adverse reactions.

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Section: Related Worksupporting

confidence: 81%

The Efficacy of Remifentanil Combined with Propofol in Craniotomy for Tumor Was Evaluated by Wake Quality, Hemodynamics, and Adverse Reactions

Zhou

Han

Chen

2022

BioMed Research International

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“…The anaesthetic protocol during AC is still under investigation. Abazieu [ 43 ] reported that remifentanil could be an independent risk factor for adverse events during AC. Remifentanil can depress the respiratory centre in the brain and cause nausea and vomiting, leading to respiratory insufficiency, prolonged hypoventilation, and conversion to general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Remifentanil can depress the respiratory centre in the brain and cause nausea and vomiting, leading to respiratory insufficiency, prolonged hypoventilation, and conversion to general anaesthesia. It should be noted that a combination of this opioid with propofol is generally recommended and used (including in the author’s centre) for the AAA protocol of anaesthesia [ 43 ]. This sedation procedure probably should be questioned, especially if we recognize that already impaired neuronal function in operated patients, due to any further imbalance, might be irreversibly damaged.…”

Section: Discussionmentioning

confidence: 99%

Awake craniotomy with dexmedetomidine during resection of brain tumours located in eloquent regions

Lechowicz-Głogowska¹,

Uryga²,

Weiser³

et al. 2022

ait

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Radical tumour resection can allow a satisfactory long-term outcome, a long life without tumour recurrence, and a shorter postoperative reconvalescence. Multiparameter intraoperative monitoring, including neuronal potentials, and clinical and psychological intraoperative evaluation of the patient, optimizes the postoperative neurological outcome [1][2][3]. However, radical tumour resection of eloquent brain tumours is associated with the risk of motor, speech, or memory disorders due to the possible injury of an eloquent brain network [4,5].

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“…13 Hemodynamic instability is defined as a systolic blood pressure of 90 mm Hg that necessitated the use of vasopressors, bleeding with a blood loss of 500 mL, transfusion, or gaseous embolism. [14][15][16] A cardiac arrest is defined as an event requiring cardiopulmonary resuscitation. The judgment of cardiac arrest is based on whether the electrocardiogram showed ventricular fibrillation, the disappearance of direct arterial blood pressure, and the reduction in mean arterial pressure to less than 20 mm Hg.…”

Section: Methodsmentioning

confidence: 99%

A Comparison of Perioperative Complications and Outcomes in Patients Undergoing Cerebral Aneurysm Clipping Performed Ultra-Early (≤ 24 hours) versus Late (> 24 hours): A 7-Year Retrospective Study of 302 Patients

Muangman,

Raksakietisak,

Vacharaksa

et al. 2024

Asian J Neurosurg

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Objectives The intracerebral aneurysm with subarachnoid hemorrhage (SAH) has a high morbidity and mortality rate. This study aimed to compare the incidences of perioperative complications in ultra-early surgery (within 24 hours) with those in late surgery (> 24 hours). Methods Retrospective data were reviewed for 302 patients who underwent craniotomies with aneurysm clipping between January 2014 and December 2020. Perioperative data were obtained from the medical records and reviewed by the investigators. The complications were compared between ultra-early and late operations. We were interested in major complications such as delayed ischemic neurologic deficit (DIND), intraoperative aneurysm rupture (IAR), and anesthesia-related complications. The short-term (in hospital) and long-term (1 year) outcomes in patients with or without DIND and IAR were compared. The collected data was statistically analyzed. Results Three hundred and two patients were analyzed, and 264 patients had completed follow-up. The ultra-early cases (150 patients) had a higher American Society of Anesthesiologists physical status, a lower Glasgow Coma Scale, and higher Hunt and Hess scales. The surgeons operated on more cases of the anterior cerebral artery as ultra-early operations. The incidence rates of DIND, IAR, severe hemodynamic instability, and cardiac arrest were 5.6, 8.3, 6.3, and 0.3%, respectively, which were not different between groups. However, the reintubation rate was higher in the ultra-early surgery cases (0 vs. 3.3%, p = 0.023). The DIND and IAR patients had poorer short-term (in hospital) outcomes. Conclusions There were no differences in major complications between ultra-early and late craniotomy with aneurysm clipping. However, the reintubation rate was strikingly higher in the ultra-early group. Patients with major complications had early, unfavorable outcomes.

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Incidence and predicting factors of perioperative complications during monitored anesthesia care for awake craniotomy

Cited by 18 publications

References 25 publications

The Efficacy of Remifentanil Combined with Propofol in Craniotomy for Tumor Was Evaluated by Wake Quality, Hemodynamics, and Adverse Reactions

The Efficacy of Remifentanil Combined with Propofol in Craniotomy for Tumor Was Evaluated by Wake Quality, Hemodynamics, and Adverse Reactions

Awake craniotomy with dexmedetomidine during resection of brain tumours located in eloquent regions

A Comparison of Perioperative Complications and Outcomes in Patients Undergoing Cerebral Aneurysm Clipping Performed Ultra-Early (≤ 24 hours) versus Late (> 24 hours): A 7-Year Retrospective Study of 302 Patients

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