Publish in this journal
Journal Information
Vol. 27. Num. 6.November - December 2016
Pages 263-316
Share
Share
Download PDF
More article options
ePub
Visits
186
Vol. 27. Num. 6.November - December 2016
Pages 263-316
Clinical Research
DOI: 10.1016/j.neucir.2016.02.004
Experience with “Fast track” postoperative care after deep brain stimulation surgery
Experiencia con el cuidado postoperatorio “Fast-Track” después de la cirugía de estimulación cerebral profunda
Visits
186
Nuria Martína, Ricard Valeroa,
Corresponding author
rvalero@clinic.ub.es

Corresponding author.
, Paola Hurtadoa, Isabel Graciaa, Carla Fernándezb, Jordi Rumiàb, Francesc Valldeoriolac, Enrique J. Carreroa, Francisco Javier Terceroa, Nicolás de Rivaa, Neus Fàbregasa
a Anesthesiology Department, Hospital Clínic de Barcelona, Spain
b Neurosurgery Department, Hospital Clínic de Barcelona, Spain
c Neurology Department, Hospital Clínic de Barcelona, Spain
This item has received
186
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (3)
Table 1. Patient characteristics.
Table 2. Intraoperative complications.
Table 3. Postoperative complications.
Show moreShow less
Abstract
Background

A 24-h-stay in the post-anesthesia care unit (PACU) is a common postoperative procedure after deep brain stimulation surgery (DBS).

Objective

We evaluated the impact of a fast-track (FT) postoperative care protocol.

Methods

An analysis was performed on all patients who underwent DBS in 2 periods: 2006, overnight monitored care (OMC group), and 2007–2013, FT care (FT group).

Results

The study included 19 patients in OMC and 95 patients in FT. Intraoperative complications occurred in 26.3% patients in OMC vs. 35.8% in FT. Post-operatively, one patient in OMC developed hemiparesis, and agitation in 2 patients. In FT, two patients with intraoperative hemiparesis were transferred to the ICU. While on the ward, 3 patients from the FT developed hemiparesis, two of them 48h after the procedure. Thirty eight percent of FT had an MRI scan, while the remaining 62% and all patients of OMC had a CT-scan performed on their transfer to the ward. One patient in OMC had a subthalamic hematoma. Two patients in FT had a pallidal hematoma, and 3 a bleeding along the electrode.

Conclusions

A FT discharge protocol is a safe postoperative care after DBS. There are a small percentage of complications after DBS, which mainly occur within the first 6h.

Keywords:
Deep brain stimulation
Parkinson's disease
Postoperative complications
Intracranial bleeding
Fast track
Postoperative care unit
Resumen
Introducción

La estancia durante 24h en una unidad de recuperación post-anestésica es una estrategia común de control post-operatorio después de la cirugía de estimulación cerebral profunda (DBS).

Objetivo

Evaluamos el impacto de un protocolo Fast-track (FT) en el cuidado postoperatorio.

Métodos

Analizamos todos los pacientes que se sometieron a cirugía DBS en 2 periodos: 2006, monitorización durante la noche (grupo OMC) y entre 2007 y 2013 (grupo FT).

Resultados

Incluimos 19 pacientes en el grupo OMC y 95 pacientes en el FT. Se registraron incidentes intraoperatorios en el 26,3% de pacientes del grupo OMC vs. 35,8% del grupo FT. Postoperatoriamente, un paciente en el grupo OMC desarrollo hemiparesia y 2 pacientes agitación. En el grupo FT, 2 pacientes con hemiparesia intraoperatoria fueron trasladados a la UCI. Durante su ingreso en planta, 3 pacientes del grupo FT desarrollaron hemiparesia, 2 de ellos 48h después del procedimiento. Al 38% del FT se les realizó una resonancia, mientras que al 62% restante y a todos los pacientes del grupo OMC se les realizó un escáner antes del traslado a sala: un paciente del grupo OMC tuvo un hematoma subtalámico; 2 pacientes del grupo FT tuvieron un hematoma en el pálido y 3, sangrado en el trayecto del electrodo.

Conclusiones

El protocolo FT es seguro después de la cirugía de DBS. Hay un pequeño porcentaje de complicaciones y la mayoría suceden en las primeras 6h.

Palabras clave:
Estimulación cerebral profunda
Enfermedad de Parkinson
Complicaciones post-operatorias
Sangrado intracraneal
Fast-track
Unidad de recuperación post-anestésica

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Idiomas
Neurocirugía (English edition)

Subscribe to our Newsletter

Article options
Tools
Cookies policy
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.