title: Experience with "Fast track" postoperative care after deep brain stimulation surgery.
abstract: A 24-h-stay in the post-anesthesia care unit (PACU) is a common postoperative procedure after deep brain stimulation surgery (DBS).
  
  
  
  We evaluated the impact of a fast-track (FT) postoperative care protocol.
  
  
  
  An analysis was performed on all patients who underwent DBS in 2 periods: 2006, overnight monitored care (OMC group), and 2007-2013, FT care (FT group).
  
  
  
  The study included 19 patients in OMC and 95 patients in FT. Intraoperative complications occurred in 26.3% patients in OMC vs. 35.8% in FT. Post-operatively, one patient in OMC developed hemiparesis, and agitation in 2 patients. In FT, two patients with intraoperative hemiparesis were transferred to the ICU. While on the ward, 3 patients from the FT developed hemiparesis, two of them 48h after the procedure. Thirty eight percent of FT had an MRI scan, while the remaining 62% and all patients of OMC had a CT-scan performed on their transfer to the ward. One patient in OMC had a subthalamic hematoma. Two patients in FT had a pallidal hematoma, and 3 a bleeding along the electrode.
  
  
  
  A FT discharge protocol is a safe postoperative care after DBS. There are a small percentage of complications after DBS, which mainly occur within the first 6h.
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Martín
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain. Electronic address: rvalero@clinic.ub.es.
authors.forename: Ricard
authors.initials: R
authors.lastname: Valero
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Paola
authors.initials: P
authors.lastname: Hurtado
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Gracia
authors.affiliation: Neurosurgery Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Carla
authors.initials: C
authors.lastname: Fernández
authors.affiliation: Neurosurgery Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Rumià
authors.affiliation: Neurology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Valldeoriola
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Carrero
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Tercero
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Nicolás
authors.initials: N
authors.lastname: de Riva
authors.affiliation: Anesthesiology Department, Hospital Clínic de Barcelona, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Fàbregas
mesh_terms: D046690:Deep Brain Stimulation; D006801:Humans; D008279:Magnetic Resonance Imaging; D010300:Parkinson Disease; D011182:Postoperative Care; D011183:Postoperative Complications; D020531:Subthalamic Nucleus; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Complicaciones post-operatorias; Deep brain stimulation; Enfermedad de Parkinson; Estimulación cerebral profunda; Fast track; Fast-track; Intracranial bleeding; Parkinson's disease; Postoperative care unit; Postoperative complications; Sangrado intracraneal; Unidad de recuperación post-anestésica