-
Tytuł:
-
Evaluation of periprocedural anxiety during Gamma Knife radiosurgery (GKRS) frame fixation for brain lesions.
-
Autorzy:
-
Pahwa B; Medical student, University college of Medical Sciences and GTB Hospital, New Delhi, India.
Kurwale N; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Agrawal D; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India. Electronic address: .
-
Źródło:
-
Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2022 Jun; Vol. 217, pp. 107242. Date of Electronic Publication: 2022 Apr 06.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Publication: Amsterdam : Elsevier
Original Publication: Assen, Van Gorcum.
-
MeSH Terms:
-
Nervous System Diseases*/etiology
Radiosurgery*/adverse effects
Radiosurgery*/methods
Anxiety/etiology ; Bradycardia/etiology ; Brain ; Follow-Up Studies ; Humans ; Prospective Studies ; Retrospective Studies ; Syncope/etiology ; Treatment Outcome
-
Contributed Indexing:
-
Keywords: Bradycardia; Gamma knife Radiosurgery; Pre operative anxiety; Steretaxy frame
-
Entry Date(s):
-
Date Created: 20220422 Date Completed: 20220519 Latest Revision: 20220614
-
Update Code:
-
20240104
-
DOI:
-
10.1016/j.clineuro.2022.107242
-
PMID:
-
35452944
-
Introduction: Application of stereotaxy frame for gamma knife under local anesthesia creates anxiety and phobia in many patients. Vasovagal syncopal attacks and events of bradycardia are not infrequently seen. We tried to analyse the various factors affecting these events and set standards and safety recommendations for the procedure.
Materials and Methods: This prospective study was carried out in Gamma Knife Centre, AIIMS, New Delhi over a 6 month period between June, 2021- November, 2021. All patients coming to Gamma knife for various etiologies were asked to fill Hamilton Anxiety Rating Scale (HAM-A) before frame application. Baseline pulse rate was evaluated and with every pin application pulse rate was recorded. A VAS (visual analogue scale) for pain was also administered after the procedure. Twenty percent fall in pulse rate were considered as significant bradycardia. Intraprocedural syncopal events were also recorded.
Results: A total of 141 patients were studied of which 6% patients had intraprocedural syncopal attacks requiring medical treatment while 32% patients had bradycardia. Having previous surgery, having breakfast before the procedure, duration of pin application, quantity of local anaesthetia, primary diagnosis, sex of patients were not found to alter the syncope or bradycardia events. Patients who were found anxious (score > 18 on HAM-A) had a significantly higher risk of having a procedural event. Previous history of syncope was also associated with 1.7 times more chances of developing Intraprocedural bradycardia.
Conclusions: Frame application for gamma-knife is a relatively safe procedure however procedure rooms should be equipped with emergency drugs and fluids for management of syncope. A Simple anxiety questionnaire can predict 'at risk' patients' for procedural events.
(Copyright © 2022. Published by Elsevier B.V.)
