Postoperative Care of Neurosurgical Patients

Abstract

Anaesthesiologists should be aware of the potential complications that can arise after intracranial neurosurgery so that they can anticipate and manage them appropriately, and also identify those patients who might benefit from postoperative admission to an intensive care unit. Complications after intracranial neurosurgery are common, occurring in almost 24 % of patients. The main issues remain major neurologic events such as postoperative intracranial bleeding and seizures. Risks factors for the development of complications have been identified, and their avoidance minimizes the risk of morbidity and mortality after elective and emergency neurosurgery. If complications do arise, timely identification and treatment are essential. Repeated clinical examination is the rule for neurological monitoring in the postoperative period. General care after intracranial procedures includes pain management, postoperative nausea and vomiting prophylaxis and thromboprophylaxis, after any surgery. Specific treatment, such as corticosteroids, antiepileptic agents and hormone replacement, may also be required in certain circumstances. Multidisciplinary care and cooperation between nurses, anaesthesiologists, intensivists and neurosurgeons are critical for the optimal postoperative management of neurosurgical patients.