Experience with "Fast track" postoperative care after deep brain stimulation surgery.

Area of Science:

• Neurosurgery
• Neurology
• Anesthesiology

Background:

• The standard postoperative care after deep brain stimulation (DBS) surgery involves a 24-hour stay in the post-anesthesia care unit (PACU).
• Evaluating alternative postoperative care protocols is essential for optimizing patient recovery and resource utilization.

Purpose of the Study:

• To assess the safety and efficacy of a fast-track (FT) postoperative care protocol for patients undergoing deep brain stimulation (DBS) surgery.
• To compare the outcomes of FT care with traditional overnight monitored care (OMC).

Main Methods:

• A retrospective analysis was conducted on patients who underwent DBS surgery.
• Patients were divided into two groups: overnight monitored care (OMC group, 2006) and fast-track care (FT group, 2007-2013).
• Complications, imaging results, and postoperative outcomes were compared between the OMC and FT groups.

Main Results:

• The study included 19 patients in the OMC group and 95 in the FT group.
• Intraoperative complications were observed in 26.3% of OMC patients and 35.8% of FT patients.
• Postoperative complications, including hemiparesis and hematomas, were infrequent in both groups, with most occurring within the first 6 hours post-surgery.

Conclusions:

• A fast-track discharge protocol is a safe postoperative management strategy for deep brain stimulation (DBS) surgery.
• The incidence of complications after DBS is low, with a majority occurring early in the postoperative period.
• FT protocols can be safely implemented, potentially improving patient flow and resource management.