Brain Endoscopy Under Local Anesthesia and Sedation: A Single-Center Experience of 510 Patients

Objective: To report the results of endoscopic transcranial intervention with local anesthesia and sedation in a busy neurosurgical centre of India. Methods: At the Department of Neurosurgery of the King George's Medical University India, more than 640 transcranial neuroendoscopic interventions have been performed for various indications over 11 years. All procedures were performed under sedation administered and monitored by a member of the neurosurgery team and local anesthesia. No head frame was used to affix the patient's head. Clinical charts from 510 patients were collected and retrospectively reviewed. Results: Overall success rate for the endoscopy procedure was 75.1% (383 of 510 patients), failures being 127 (24.9%). Fifty-four procedures had to be abandoned (10.6%), and in the remaining 73 patients, the endoscopic treatment did not obtain the expected clinical result. Overall complication rate was 16.9% (86 patients) with a mortality rate of 1.2% (6 patients). Patients did not complain of any discomfort related to the sedation after the procedure, and we did not directly relate any surgical complication to the sedation. Conclusions: This study proves the versatility and effectiveness of neuroendoscopy in the management of a wide group of neurosurgical conditions in a developing country. The feasibility of brain endoscopy under local anesthesia is also presented. Categories: Neurosurgery