Postoperative surveillance in neurosurgical patients – usefulness of neurological assessment scores and bispectral index

Herrero, S. Navarro; Carrero, Enrique; Valero, Ricard; Ríos, José; Fàbregas, Neus

doi:10.1016/j.bjane.2015.09.003

Cited by 15 publications

(10 citation statements)

References 27 publications

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“…A total of 4290 studies were screened on the title/abstract. Eventually, 47 studies were assessed full text, of which 27 excluded: delirium diagnosis not reproducible ( n s (number of studies) = 9), [ 20 – 28 ] full text not found ( n s = 3), [ 29 – 31 ] duplicate ( n s = 3), [ 18 , 32 ] paediatric patients ( n s = 1) [ 33 ], overlapping populations ( n s = 3), [ 4 , 34 , 35 ] no delirium assessment ( n s = 1), [ 36 ] no original data ( n s = 2) [ 37 , 38 ] and an unclear number of patients undergoing intracranial surgery ( n s = 5) [ 39 – 43 ]. Finally, 20 paper were included in the qualitative analysis and 18 papers in the quantitative analysis ( n p (number of patients) = 5083).…”

Section: Resultsmentioning

confidence: 99%

Delirium in neurosurgery: a systematic review and meta-analysis

et al. 2021

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Delirium is a frequent occurring complication in surgical patients. Nevertheless, a scientific work-up of the clinical relevance of delirium after intracranial surgery is lacking. We conducted a systematic review (CRD42020166656) to evaluate the current diagnostic work-up, incidence, risk factors and health outcomes of delirium in this population. Five databases (Embase, Medline, Web of Science, PsycINFO, Cochrane Central) were searched from inception through March 31st, 2021. Twenty-four studies (5589 patients) were included for qualitative analysis and twenty-one studies for quantitative analysis (5083 patients). Validated delirium screening tools were used in 70% of the studies, consisting of the Confusion Assessment Method (intensive care unit) (45%), Delirium Observation Screening Scale (5%), Intensive Care Delirium Screening Checklist (10%), Neelon and Champagne Confusion Scale (5%) and Nursing Delirium Screening Scale (5%). Incidence of post-operative delirium after intracranial surgery was 19%, ranging from 12 to 26% caused by variation in clinical features and delirium assessment methods. Meta-regression for age and gender did not show a correlation with delirium. We present an overview of risk factors and health outcomes associated with the onset of delirium. Our review highlights the need of future research on delirium in neurosurgery, which should focus on optimizing diagnosis and assessing prognostic significance and management.

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Section: Resultsmentioning

confidence: 99%

Delirium in neurosurgery: a systematic review and meta-analysis

et al. 2021

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“…Um item não levantado a priori, como objetivo do estudo, mas que apresentou destaque no decorrer da pesquisa foi a ausência do carimbo profissional após o registro, foi evidenciado que de 356 registros, 94 (17,5%) não constavam carimbo, apenas o nome por extenso e número do Conselho Regional de Enfermagem (COREN). Estudo evidenciou que a avaliação conjunta do reflexo pupilar e da ECGl são úteis na estimativa de ocorrência de complicações neurológicas no pósoperatório de craniotomias 11 . Embora a evidência supracitada aponte para a necessidade da avaliação concomitante (avaliação do nível de consciência e pupila), o resultado do presente estudo, demonstrou que houve maior quantidade de registros do nível de consciência, que registros de avaliação pupilar.…”

Section: Resultsunclassified

Quality of nurses' records concerning neurological assessments in a specialized intensive care unit

Mota¹,

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Dourado³

et al. 2021

Mundo Saúde

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“…(19). Herrero et al (20) compared different methods in the assessment of postoperative neurological complications in neurosurgical patients, and reported that; applied together, the assessment of pupils, Glasgow, Coma Scale, RSS, CNS, The Nursing Delirium Screening Scale (Nu-DESC) and BIS improved early detection of postoperative neurological complications in Post anesthesia care unit (PACU) after elective craniotomies. Yang et al (21) reported that t the number of sedation-related adverse events appears to be lower when BIS was used although the mean level of sedation does not change significantly.…”

Section: Resultsmentioning

confidence: 99%

Correlation between Ramsay Sedation Scale and Richmond Agitation-Sedation Scale with Bispectral Index Monıtoring in the Intensive Care Unit

2018

ARC Journal of Anesthesiology

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Background: Achieving appropriate sedation levels in mechanically ventilated patients is very crucial in intensive care units. Reaching and keeping appropriate level of sedation in these patients is a common problem.. By reaching appropriate sedation and analgesia, comfort and easier adoption to weaning is aimed. For adequate and appropriate sedation, monitoring the sedation level is needed. Different scoring techniques are used for this purpose. Our aim is to compare Bispectral index (BIS) monitoring, which is an objective method, with subjective clinical sedation scales, and to investigate the correlation between them. Methods: Data of patients, whom sedation and mechanical ventilation were performed in postoperative period, were analysed retrospectively. All patients with comorbidities which cause altered brain function and who needed inotropic drugs were excluded from the study. Richmond Sedation Scale (RSS) levels were held between +2-+3, and Richmond Agitation Sedation Scale (RASS), BIS and hemodynamic parameters were recorded in every hour for 6 hours. Results: A negative correlation between BIS and clinical sedation scales was observed in patients who had superficial sedation. RASS levels ranged from 0 to "-3", and average BIS value was 75. The average BIS value at RAMSAY

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Postoperative surveillance in neurosurgical patients – usefulness of neurological assessment scores and bispectral index

Abstract: Applied together, the assessment of pupils, GCS, Ramsay scale, CNS, Nu-DESC and BIS improved early detection of postoperative neurological complications in PACU after elective craniotomies.

Cited by 15 publications

References 27 publications

Delirium in neurosurgery: a systematic review and meta-analysis

Delirium in neurosurgery: a systematic review and meta-analysis

Quality of nurses' records concerning neurological assessments in a specialized intensive care unit

Correlation between Ramsay Sedation Scale and Richmond Agitation-Sedation Scale with Bispectral Index Monıtoring in the Intensive Care Unit

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