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Anaesth Crit Care Pain Med ; 36(4): 213-218, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27717899

RESUMO

INTRODUCTION: After elective craniotomy for brain tumour surgery, patients are usually admitted to an intensive care unit (ICU) for monitoring. Our goal was to evaluate the incidence and timing of neurologic and non-neurologic postoperative complications after brain tumour surgery, to determine factors associated with neurologic events and to evaluate the timing and causes of ICU readmission. PATIENTS AND METHODS: This prospective, observational and analytic study enrolled 188 patients admitted to the ICU after brain tumour surgery. All postoperative clinical events during the first 24hours were noted and classified. Readmission causes and timing were also analysed. RESULTS: Twenty-one (11%) of the patients were kept sedated after surgery; the remaining 167 patients were studied. Thirty one percent of the patients presented at least one complication (25% with postoperative nausea and vomiting (PONV), 16% with neurologic complications). The occurrence of neurological complications was significantly associated with the absence of preoperative motor deficit and the presence of higher intraoperative bleeding. Seven patients (4%) were readmitted to the ICU after discharge; 43% (n=3) of them had a posterior fossa surgery. CONCLUSION: Postoperative complications, especially PONV, are frequent after brain tumour surgery. Moreover, 16% of patients presented a neurological complication, probably justifying the ICU postoperative stay for early detection. The absence of preoperative motor deficit and intraoperative bleeding seems to predict postoperative neurologic complications. Finally, patients may present complications after ICU discharge, especially patients with fossa posterior surgery, suggesting that ICU hospitalization may be longer in this type of surgery.


Assuntos
Neoplasias Encefálicas/cirurgia , Craniotomia/efeitos adversos , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Perda Sanguínea Cirúrgica , Neoplasias Encefálicas/mortalidade , Fossa Craniana Posterior/cirurgia , Craniotomia/mortalidade , Cuidados Críticos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/epidemiologia , Transtornos dos Movimentos/etiologia , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/terapia , Readmissão do Paciente , Complicações Pós-Operatórias/mortalidade , Náusea e Vômito Pós-Operatórios/terapia , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco
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