• World Neurosurg · Oct 2021

    Monitored Anesthetic Care Combined with Scalp Nerve Block in Awake Craniotomy: an Effective Attempt at Enhanced Recovery after Neurosurgery.

    • Yan-Jun Chen, Cai Nie, Hao Lu, Liu Zhang, Hong-Lin Chen, Shi-Yong Wang, Wei Li, Si Shen, and Hao Wang.
    • Department of Anesthesiology, The First Affiliated Hospital, Jinan University, Guangzhou, People's Republic of China.
    • World Neurosurg. 2021 Oct 1; 154: e509-e519.

    BackgroundEnhanced recovery after surgery has been attempted in neurosurgery at a greater rate. However, concern exists regarding the feasibility of using enhanced recovery after neurosurgery (ERANS). How to manage available resources to safely perform ERANS and improve clinical outcomes has been the subject of much debate and discussion.MethodsOwing to the paucity of data available on the use of ERANS protocols, we performed the present feasibility study. We studied the outcomes of the protocols used within a tertiary referral neurosurgery center. Data from patients who had undergone awake craniotomy within an ERANS protocol were prospectively recorded in our institution from September 2017 to December 2018. We also evaluated the safety and effectiveness of the novel ERANS protocol.ResultsA total of 20 patients (mean age, 49.5 ± 17.8 years) were included in the present study. Intraoperative hypertension, hypotension, and bradycardia were present in 4 (20%), 1 (5%), and 1 (5%) patient, respectively. The postoperative morbidities included epilepsy in 1 (5%), pain in 3 (15%), and nausea or vomiting in 2 (10%). No significant changes had occurred in the mean arterial pressure, heart rate, blood glucose, or lactic acid level throughout the procedure. The median length of intensive care unit stay and postoperative hospital stay were 1 and 9.5 days, respectively. No 30-day readmissions or reoperations occurred during the present study.ConclusionsApplying an ERANS protocol was feasible, associated with a low incidence of complications, and acceptable intensive care unit and postoperative hospital lengths of stay. The findings from the present study might provide a new approach for the further research of ERANS.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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