gms | German Medical Science

Objective: Patients with refractory epilepsy are often admitted to intensive care unit (ICU) postoperatively following an elective craniotomy. The aim of this study was to determine the occurrence rate of significant complications during the postoperative observation at ICU to estimate the need of ICU requirement.

Methods: The data was analyzed from patients with elective craniotomy who had undergone resective epilepsy surgery (anterior temporal lobectomy, selective amygdala hippocampectomy, lesionectomy or hemispherectomy) in the period from 2015 to 2017. All patients were presurgically assessed in the department of epileptology. Analysis included adults 18 years of age or older who were eligible for epileptic surgery according to pre-surgical criteria. The clinical characteristics, surgical complications, ASA classification, duration of surgery and blood loss were evaluated and analyzed.

Results: A total of 112 patients were included in the analysis. Mean age was 39y±13.4, mean duration of surgery was 257min±63.74, mean intraoperative blood loss was 296ml±248.80. ASA score ≤2 was identified in 102(91%) patients. In 10(9%) patient, the ASA score was ≥3. The analysis revealed the occurrence of significant complications required ICU care in 3(2.6%) patients. The comparison between these patients and patients without occurrence of ICU relevant complications showed no significant difference with regard to ASA score and age. A significant higher intraoperative blood loss (p≤0.0001) and longer duration of surgery (p=0,0069) was observed in patients with ICU relevant complications.

Conclusion: The rate of complications requiring intensive care monitoring after elective craniotomies in epilepsy surgery is low. However, patients with a long duration of surgery and high blood loss require intensive care monitoring after elective craniotomies more often. Therefore, post-operative ICU monitoring may not be routinely required in all patients.