Lashmi Venkatraghavan1,2, Suparna Bharadwaj3, Karolyn Au4, Mark Bernstein4, Pirjo Manninen3. 1. Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. lashmi.venkatraghavan@uhn.on.ca. 2. Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. lashmi.venkatraghavan@uhn.on.ca. 3. Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. 4. Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
Abstract
PURPOSE: Enhanced Recovery After Surgery is a multimodal perioperative care pathway designed to achieve early discharge in patients undergoing major surgery. Recent advances in neurosurgery allow for shorter duration of anesthesia and surgery, faster recovery, and earlier discharge from hospital. The purpose of this retrospective observational study was to assess the incidence of early discharge from hospital in patients undergoing craniotomy for supratentorial brain tumours as well as to explore the associated perioperative factors, anesthesia techniques, and complications. METHODS: The medical records of all patients who underwent craniotomy (less than four-hour duration) for supratentorial tumour over a five-year period were retrospectively reviewed. The data analyzed included the postoperative discharge destination, type of anesthesia-i.e., general anesthesia (GA) vs awake craniotomy (AC), and the incidence of adverse events. RESULTS: Data from 329 patients [mean (SD) age 48 (12) yr; 164 male, 165 female] were analyzed, including 198 (AC, n = 157; GA, n = 41) patients who were preoperatively scheduled for same-day discharge. Successful same-day discharge occurred in 175/198 (88.4%) of these patients (AC, n = 139; GA, n = 36). Five (2.9%) of the 175 patients (4 AC, 1 GA) with same-day discharge required readmission to hospital within the first 12 hr after discharge. Six (1.8%) of the 329 total patients had a documented postoperative intracranial bleed, but none occurred after initial discharge from hospital. CONCLUSION: Same-day discharge from hospital is possible in carefully selected patients after both GA and AC for supratentorial tumour surgery.
PURPOSE: Enhanced Recovery After Surgery is a multimodal perioperative care pathway designed to achieve early discharge in patients undergoing major surgery. Recent advances in neurosurgery allow for shorter duration of anesthesia and surgery, faster recovery, and earlier discharge from hospital. The purpose of this retrospective observational study was to assess the incidence of early discharge from hospital in patients undergoing craniotomy for supratentorial brain tumours as well as to explore the associated perioperative factors, anesthesia techniques, and complications. METHODS: The medical records of all patients who underwent craniotomy (less than four-hour duration) for supratentorial tumour over a five-year period were retrospectively reviewed. The data analyzed included the postoperative discharge destination, type of anesthesia-i.e., general anesthesia (GA) vs awake craniotomy (AC), and the incidence of adverse events. RESULTS: Data from 329 patients [mean (SD) age 48 (12) yr; 164 male, 165 female] were analyzed, including 198 (AC, n = 157; GA, n = 41) patients who were preoperatively scheduled for same-day discharge. Successful same-day discharge occurred in 175/198 (88.4%) of these patients (AC, n = 139; GA, n = 36). Five (2.9%) of the 175 patients (4 AC, 1 GA) with same-day discharge required readmission to hospital within the first 12 hr after discharge. Six (1.8%) of the 329 total patients had a documented postoperative intracranial bleed, but none occurred after initial discharge from hospital. CONCLUSION: Same-day discharge from hospital is possible in carefully selected patients after both GA and AC for supratentorial tumour surgery.
Authors: Paul T Akins; Amit Banerjee; Kern Guppy; James Silverthorn; John Fitzgibbon; Yogesh Nandan; Elaine O Yu; Luis Pacheco; Jack Rozance; Rob Azevedo; James Chang; Mark W Hawk Journal: Perm J Date: 2019-10-18
Authors: Regin Jay Mallari; Michael B Avery; Alex Corlin; Amalia Eisenberg; Terese C Hammond; Neil A Martin; Garni Barkhoudarian; Daniel F Kelly Journal: PLoS One Date: 2021-07-29 Impact factor: 3.240