• Aslan Guzel, Sedat Kaya, Umit Ozkan, M Ufuk Aluclu, Adnan Ceviz, and Deniz Belen.
• Neurosurgery Department, Dicle University, Diyarbakir, Turkey. aslang@dicle.edu.tr
• Swiss Med Wkly. 2008 Jul 12;138(27-28):398-403.

Questions Under StudyGeneral and local uses of anaesthesia are the preferred common methods in the surgical treatment of chronic subdural haematoma (CSDH). The literature provides no information regarding monitored anaesthesia care during surgery of CSDH. In this report we evaluate the clinical results of surgical treatment for CSDH under monitored anaesthesia care.MethodBetween 2001 and 2006 twenty consecutive patients with 24 CSDHs were surgically treated under monitored anaesthesia care at one institution. The clinical success of the procedure under monitored anaesthesia care, patient satisfaction, length of hospitalisation, anaesthesia-related complications and neurological outcome were analysed.ResultsMean age was 60.9 years, with 15 patients aged over 60. ASA physical condition score was IV in 11 patients, III in 1, II in 4 and I in 4. In all patients CSDH was successfully drained by burr hole craniotomy under monitored anaesthesia care. There was no anaesthesia-related morbidity or mortality. Mean hospital stay was 4.5 days.ConclusionPreliminary results indicate that surgery for CSDH under monitored anaesthesia care is safe and effective. Conscious sedation using monitored anaesthesia care, that is a middle ground between general anaesthesia and local anaesthesia, may facilitate patient comfort and surgical competence during surgery for CSDH.

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