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Early postoperative complications following neurosurgical procedures

  • Pirjo H. Manninen
  • Sitaram K. Raman
  • Kevin Boyle
  • Hossam El-Beheiry
Reports of Investigation

Abstract

Purpose

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.

Keywords

Intensive Care Unit Respiratory Complication Stereotactic Biopsy Neurosurgical Procedure Neurosurgical Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Évaluer les caractéristiques et l’incidence de complications postopératoires précoces chez des patients qui ont subi une intervention neurochirurgicale.

Méthode

Pendant quatre mois, tous les patients qui avaient subi une neurochirurgie ont été suivis, pendant une période pouvant aller jusqu’à quatre heures, à la salle de réveil ou à l’unité des soins intensifs. Les chercheurs ont noté sur un formulaire standardisé les informations recueillies auprès du patient et toutes les complications. Ces dernières ont été classées en complications respiratoires, cardiovasculaires, nausées et vomissements, frissons et autres. Les facteurs de risques analysés selon la survenue des complications comprenaient l’âge, le sexe, l’état ASA, le type de chirurgie, l’aspect prévisible ou non de la chirurgie et le placement postopératoire.

Résultats

Quatre cent quatre-vingt six patients adultes ont été suivis, mais on a exclu 55 patients de l’analyse des complications postopératoires puisqu’ils ont eu besoin d’intubationpendant les quatre heures de l’expérience. 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 aériennes chez 4,4 % et des nausées et/ou des vomissements chez 38 %. La plus forte incidence de complications a été enregistrée pendant la chirurgie rachidienne (65 %) et vasculaire (66 %), comparativement à la chirurgie pour une tumeur (47 %) ou à d’autres chirurgies (43 %),P < 0,05. Les autres facteurs de risque comprenaient l’âge < 70 ans pour les nausées et les vomissements (P < 0,02) et le caractère non urgent de la chirurgie rachidienne et vasculaire (P < 0,001 ).

Conclusion

Il y a eu une forte incidence de complications postopératoires précoces chez les patients admis en neurochirurgie. Les nausées et les vomissements se sont présentés le plus souvent et surtout chez les jeunes patients subissant une chirurgie rachidienne.

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Copyright information

© Canadian Anesthesiologists 1999

Authors and Affiliations

  • Pirjo H. Manninen
    • 1
  • Sitaram K. Raman
    • 1
  • Kevin Boyle
    • 1
  • Hossam El-Beheiry
    • 1
  1. 1.Department of AnesthesiaUniversity of Toronto, The Toronto Hospital, Western DivisionTorontoCanada

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