Perioperative Management of Neurosurgical Emergencies at the Owendo University Hospital Center, Gabon

The perioperative management of neurosurgical emergencies presents a challenge for the anesthesiologist-intensivist. The objective of this study was to describe the perioperative management of patients undergoing emergency surgery for neurosurgical conditions at the Owendo University Hospital Center. Methodology: This was a descriptive cross-sectional study with retrospective data collection. The records of patients who underwent emergency surgery for neurosurgical conditions within the first 24 hours following diagnosis were included. Clinical data, surgical indications, and anesthesiological management data were analyzed. Statistical analysis was performed using SPSS version 23. Results: During the study period, 109 patients were included. Their mean age was 42 ± 24.5 years, with a male predominance. Patients under 10 years of age represented 13.8%. Acute subdural hematoma (35 patients, 32.1%) and acute hydrocephalus (14 patients, 12.8%) were the main surgical indications. The mean Glasgow Coma Scale (GCS) score was 12. Regarding anesthetic risk, 25 patients (56%) were classified as ASA 1. General anesthesia with orotracheal intubation was the standard procedure. Propofol (80%), suxamethonium (79%), and sufentanil were the most frequently used anesthetic drugs. The mean duration of anesthesia was 176 ± 70 minutes, and the mean duration of surgery was 119 ± 65 minutes. A mortality rate of 35.8% was recorded. Conclusion: Perioperative management of neurosurgical emergencies is multidisciplinary. Traumatic emergencies are predominant.