Introduction: Healthcare-associated harm represents a significant challenge, with an incidence of up to 6% across diverse healthcare settings. Medication-related events represent a leading contributor. This study aimed to characterize the frequency and severity of potential perioperative drug-drug interactions (pDDIs) in patients undergoing neurosurgical procedures. MaterialsandMethods: A retrospective observational study was conducted among patients undergoing neurosurgical procedures at Hospital ángeles Lomas between January and June 2023. Data were collected from electronic medical records. All concomitant perioperative drug combinations recorded in the medical record were analyzed using Micromedex？, and potential drug-drug interactions (pDDIs) were identified and classified by severity as minor, moderate, or major. Results: Ninety-one patients were included in the final analysis, at least one pDDI was identified in all patients, with a median of 30 (IQR 20 - 43). A positive correlation was observed between the number of medications and total pDDIs (rs = 0.796, p < 0.001). A higher pDDI burden was observed among patients aged ≥ 60 years and those with multiple comorbidities, although these differences were not statistically significant. Patients receiving baseline pharmacological treatment had significantly more pDDIs than those without baseline treatment (p = 0.019). Differences were also observed according to anesthetic technique (p = 0.026). Patients admitted to critical care settings showed a higher median number of pDDIs compared with those in general wards; however, these differences did not reach statistical significance (p = 0.130). Most patients (98.9%) were discharged with clinical improvement. Conclusion: Potential drug-drug interactions (pDDIs) were frequently identified among patients undergoing neurosurgical procedures and were associated with perioperative medication exposure, baseline pharmacological treatment and anesthetic technique. These findings highlight the substantial pharmacological complexity of the perioperative neurosurgical setting and support the need for careful medication review during perioperative care.
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