Enhanced recovery after surgery for oncological craniotomies

Hagan, Katherine; Bhavsar, Shreyas; Raza, Shaan M.; Arnold, Benjamin; Arunkumar, Radha; Dang, Anh; Gottumukkala, Vijay; Popat, Keyuri; Pratt, Greg; Rahlfs, Tom F; Cata, Juan P.

doi:10.1016/j.jocn.2015.08.013

Cited by 89 publications

(64 citation statements)

References 59 publications

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“…However, to the best of our knowledge, application of an ERAS protocol for infratentorial craniotomy has not yet been reported. Hagan et al proposed some key components of ERAS applicable to craniotomy based on evidence available from other surgical specialties [10].…”

Section: Introductionmentioning

confidence: 99%

"RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

Wang

Zhao

et al. 2020

BMC Neurol

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Background: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group.

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Section: Introductionmentioning

confidence: 99%

"RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

Wang

Zhao

et al. 2020

BMC Neurol

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“…In addition, due to changes in intracranial pressure and the residual effects of narcotic drugs, some patients (including ERAS and control group) experienced postoperative nausea and vomiting, and carbohydrate enriched fluid treatment could not reduce postoperative discomfort [36], which affected the recovery of postoperative diet. Although less evidences support the postoperative nutritional support is typically needed for brain tumor patients, with the exception of patients who are in a prolonged comatose state [37], our data demonstrated the validity of ERAS program.…”

Section: Discussionmentioning

confidence: 56%

Evaluation of the effect of ERAS to nutritional status of patients with elective craniotomy using bioelectrical impedance analysis: a prospective and randomized controlled trial

Jin

Wang

et al. 2019

Preprint

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Background The aim of the present study was to test the body composition changes of patients undergoing elective craniotomy using bioelectrical impedance analysis, so as to evaluate the effect of enhanced recovery after surgery (ERAS) to nutritional status of patients. Methods 140 patients who needed elective craniotomy were randomly divided into two groups: observation group (ERAS group) and control group (traditional treatment group). The age was 45.6 ± 12.7 years old. Patients in ERAS group were treated with a set of enhanced recovery measures, while control group patients underwent conventional treatment. Bioelectrical impedance analysis was used to test body composition before and after the surgery. Results The body mass (BM), body mass index (BMI), fat mass (FM), muscle mass (MM), fat mass index (FMI), free-fat mass index (FFMI), body cell mass (BCM), body cell mass index (BCMI), in both groups were decreased after surgery. The decrease of FM and FMI in the control group was significantly different from that in the observation group (p<0.05). However, the decrease of BM, BMI, MM, FFMI, BCM and BCMI in both groups were not statistically significant. Conclusion Patients undergoing elective craniotomy showed various degrees of nutritional injuries, and ERAS could alleviate nutritional injuries caused by operation. Keywords Enhanced Recovery after Surgery • Bioelectrical impedance analysis • Elective craniotomy Trail Registration Chinese Clinical Trial Registry, ChiCTR-INR-16009662. Registered on 27 October 2016. Trail Registration Chinese Clinical Trial Registry, ChiCTR-INR-16009662. Registered on 27 October 2016.

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“…The prospect of decreasing volume loading may be especially appealing in patients with hypocoagulation as well as in patients with cardiac compromise. The decreased or avoided use for vasopressor support may be particularly advantageous for enhanced recovery, 23 especially in the elderly and/or ASA III patients who have increased length of hospital stay after craniotomy for brain tumors. 24 Further RCTs are needed to demonstrate that the expected benefits accrue from less fluid and vasopressor administration in neurosurgical patients.…”

Section: Hemodynamic Effects: Maintenance Of Stable Systemic Blood Prmentioning

confidence: 99%

Protecting the Brain With Xenon Anesthesia for Neurosurgical Procedures

Rylova

Maze

2019

Journal of Neurosurgical Anesthesiology

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Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery. Although the expense of this rare monoatomic gas will likely prevent its widespread penetration into routine clinical neurosurgical practice, we draw attention to the theoretical benefits of xenon anesthesia over other anesthetic regimens for awake craniotomy and for neurosurgery in older, high-risk, and sicker patients.

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Enhanced recovery after surgery for oncological craniotomies

Cited by 89 publications

References 59 publications

"RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

"RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

Evaluation of the effect of ERAS to nutritional status of patients with elective craniotomy using bioelectrical impedance analysis: a prospective and randomized controlled trial

Protecting the Brain With Xenon Anesthesia for Neurosurgical Procedures

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