A retrospective analysis of perioperative complications during intracranial neuroendoscopic procedures: Our institutional experience

Background: Neuroendoscopic procedures are now being performed more frequently, and with advancement in technology, complications related to the procedure and equipments have also minimized or changed. We report our experience with 223 patients who underwent intracranial neuroendoscopic procedures.
Materials and Methods: The rates of various perioperative complications, both surgical and anesthesia related, during intracranial neuroendoscopic surgeries were studied. Data collected included demographics, patient′s medical history and any associated comorbid conditions, diagnosis, procedure performed, anesthetic management, intraoperative and postoperative complications and outcomes.
Results: Of the 223 patients studied, 119 were pediatric (age <14 years) and 104 were adults. Hypothermia (25.1%) and cardiovascular complications (such as tachycardia 18.8%, bradycardia 11.3%, hypertension 16.1%, and hypotension 16.6%) were the commonly observed complications during intraoperative period both in pediatric and adult patients. At the end of the procedure, delayed arousal was observed in 17 patients and 19 patients required postoperative ventilatory support. Postoperative frequent complications included: fever (34.1%), tachycardia (32.7%), nausea and vomiting (18.8%). Potentially fatal complications such as intraoperative hemorrhage, air embolism, etc. were rare. Most of the complications were transient and self-limiting.
Conclusion: Although endoscopic procedures are considered minimally invasive, at times may lead to life-threatening complications and one should be aware of them.

Keywords
Anesthesia, cardiovascular complications, intracranial surgery, minimally invasive, neuroendoscopy, surgical complications