Management of Postoperative Care in Neurosurgery

Dear Colleagues,

Postoperative care in neurosurgery is extremely complex and requires the care of various types of patients. This includes especially patients with neurotrauma, in whom, in addition to treating the central nervous system injury, accompanying injuries to other organs and systems must be treated, as well as the patient's comorbid conditions such as diabetes, hypertension or infections. Nutrition of patients with neurotrauma is particularly complex due to peristalsis disorders that often accompany central nervous system injuries. Early initiation of oral nutrition in awake patients, enteral nutrition in ventilator patients, or parenteral nutrition in situations where the gastrointestinal tract is dysfunctional should help maintain homeostasis in these patients. By preventing the occurrence of anemia, hypoproteinemia or electrolyte imbalances, early clinical nutrition is one of the measures that can help the patient in the sensitive period after an acute brain injury. The care of patients who undergo elective neurosurgical procedures is increasingly done according to the key principles of Enhanced Recovery After Surgery (ERAS). Postoperative pain control, early physical therapy, mobilization, and patient education are key elements of patient care after elective neurosurgical procedures. Implementation of ERAS protocols after elective neurosurgical procedures has shown improved outcomes but is still a challenge for emergency patients, especially those with impaired cognitive status. Determining the category of emergency patients who would benefit from the ERAS protocol may reduce the invasiveness of their treatment, the number of catheterization days, the number of central venous catheters, and thus the frequency of treatment complications. Along with postoperative pain management, infection prevention, and early neurorehabilitation, these aspects of treatment can improve postoperative recovery in neurosurgical patients. The goal of this Special Issue is to emphasize the importance of the previously mentioned aspects of postoperative treatment, and other interventions that can contribute to advances in the postoperative care of neurosurgical patients.

Dr. Slavica Kvolik
Guest Editor

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