Patient perception and satisfaction in awake burr hole trepanation under local anesthesia for evacuation of chronic subdural hematoma

Clin Neurol Neurosurg. 2024 Jan:236:108085. doi: 10.1016/j.clineuro.2023.108085. Epub 2023 Dec 14.

Abstract

Evacuation of chronic subdural hematoma (CSDH) will be one of the most common neurosurgical procedures in the future in the increasingly aging societies. Performing cranial surgery on awake patients may place a psychological burden on them. Aim of this study was to evaluate the psychological distress of patients during awake CSDH relief. Patients with awake evacuation of CSDH via burr hole trepanation were included in our monocentric prospective study. Patient perception and satisfaction were measured using standardized surveys 3-5 days and 6 months after surgery. Among other questionnaires, the Hospital Anxiety and Depression and the Impact of Event Scale, were used to quantify patients' stress. A total of 50 patients (mean age 72.9 years (range 51 - 92)) were included. During surgery, 28 patients reported pain (mean 4.1 (SD 3.3)). Postoperatively, 26 patients experienced pain (mean 2.7 (SD 2.6)). Patients' satisfaction with intraoperative communication was reported with a mean of 8.3 (SD 2.1). There was a significant negative correlation between intraoperatively perceived pain and satisfaction with intraoperative communication (p = 0.023). Good intraoperative communication during evacuation of CSDH in awake patients is associated with positive patient perception and correlates with pain reduction.

Keywords: Awake surgery; Burr hole trepanation; Chronic subdural hematoma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Local
  • Drainage / methods
  • Hematoma, Subdural, Chronic* / surgery
  • Humans
  • Middle Aged
  • Pain / surgery
  • Patient Satisfaction
  • Perception
  • Personal Satisfaction
  • Prospective Studies
  • Trephining / methods
  • Wakefulness