Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2022

Open Access 01-12-2022 | Study protocol

The effect of postoperative early lumbar drainage on delayed fever after cerebellopontine angle tumour surgery: study protocol for a randomized controlled trial

Authors: Yunze Zhang, Yingxi Wu, Yang Wu, Gang Zhu, Yafei Xue, Yan Qu, Tianzhi Zhao

Published in: Trials | Issue 1/2022

Login to get access

Abstract

Background

Postoperative fever is one of the common complications in neurosurgery, and intracranial aseptic inflammation and infection are important risk factors. Continuous drainage of cerebrospinal fluid (CSF) via lumbar drainage (LD) is often used in the treatment of postoperative intracranial infection or aseptic inflammation. Compared with the previously reported placement of LD after the onset of meningitis symptoms, we designed this randomized controlled trial (RCT) to evaluate the effectiveness and safety of early drainage (1st day postoperation) of CSF using the preset lumbar cistern to prevent delayed fever (fever occurred after the third day postoperation) or reduce its treatment time after cerebellopontine angle (CPA) tumour surgery.

Methods

Patients suffering from CPA tumours and who underwent resection of the tumour with an intraoperative dura opening time > 4 h are recruited for this study. The study is a 2-arm RCT to compare the early LD group and the no early LD group. Postoperative duration and rate of delayed fever and postoperative length of stay (LOS), as the main outcomes, will be compared in the two groups.

Discussion

Here, we present the study design of a prospective RCT to evaluate the safety and efficacy of using preoperative preset LD to treat or reduce postoperative delayed fever.

Trial registration

China Clinical Trial Registry ChiCTR2100049057. Registered on July 20, 2021.
Literature
1.
Chatzisotiriou AS, Selviaridis PK, Kontopoulos VA, Kontopoulos AV, Patsalas IA. Delayed persistent hyperthermia after resection of a craniopharyngioma. Pediatr Neurosurg. 2004;40(4):196–202.CrossRef
2.
Chen JX, Alkire BC, Lam AC, Curry WT, Holbrook EH. Aseptic meningitis with craniopharyngioma resection: consideration after endoscopic surgery. J Neurol Surg Rep. 2016;77(4):e151–5.CrossRef
3.
Kourbeti IS, Vakis AF, Ziakas P, et al. Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis. J Neurosurg. 2015;122(5):1113–9.CrossRef
4.
Carmel PW, Greif LK. The aseptic meningitis syndrome: a complication of posterior fossa surgery. Pediatr Neurosurg. 1993;19(5):276–80.CrossRef
5.
Wakamoto H, Miyazaki H, Orii M, et al. Aseptic meningitis as a complication caused by an allergic reaction after microvascular decompression: two case reports. No Shinkei Geka. 2002;30(12):1331–5.
6.
Fugate JE. Complications of neurosurgery. Continuum (Minneap Minn). 2015;21(5 Neurocritical Care):1425–44.
7.
Valentini L, Chiaffarino F, Bonfanti N, et al. Incidence and risk factors of neurosurgical site infections: results of a prospective multicenter cohort study on 6359 surgeries. J Neurosurg Sci. 2021;65(1):24–32.CrossRef
8.
Ren Y, Liu X, You C, et al. Efficacy of closed continuous lumbar drainage on the treatment of postcraniotomy meningitis: a retrospective analysis of 1062 cases. World Neurosurg. 2017;106:925–31.CrossRef
9.
Fang Y, Shao Y, Lu J, et al. The effectiveness of lumbar cerebrospinal fluid drainage in aneurysmal subarachnoid hemorrhage with different bleeding amounts. Neurosurg Rev. 2020;43(2):739–47.CrossRef
10.
Panni P, Donofrio CA, Barzaghi LR, et al. Safety and feasibility of lumbar drainage in the management of poor grade aneurysmal subarachnoid hemorrhage. J Clin Neurosci. 2019;64:64–70.CrossRef
11.
Atkinson JL, Weinshenker BG, Miller GM, Piepgras DG, Mokri B. Acquired Chiari I malformation secondary to spontaneous spinal cerebrospinal fluid leakage and chronic intracranial hypotension syndrome in seven cases. J Neurosurg. 1998;88(2):237–42.CrossRef
12.
Payner TD, Prenger E, Berger TS, Crone KR. Acquired Chiari malformations: incidence, diagnosis, and management. Neurosurgery. 1994;34(3):429–34 discussion 434.CrossRef
13.
Tan J, Song R, Huan R, Huang N, Chen J. Intraoperative lumbar drainage can prevent cerebrospinal fluid leakage during transsphenoidal surgery for pituitary adenomas: a systematic review and meta-analysis. BMC Neurol. 2020;20(1):303.CrossRef
14.
Wu Y, Zhang Y, Wu Y, et al. Postoperative early lumbar drainage can reduce the duration of fever or infection in patients with complicated intracranial tumors after a long operation time. Neurol India. 2022;70(4):1435–42.CrossRef
15.
O’Keeffe AB, Lawrence T, Bojanic S. Oxford craniotomy infections database: a cost analysis of craniotomy infection. Br J Neurosurg. 2012;26(2):265–9.CrossRef
16.
McClelland SR, Hall WA. Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures. Clin Infect Dis. 2007;45(1):55–9.CrossRef
17.
Dashti SR, Baharvahdat H, Spetzler RF, et al. Operative intracranial infection following craniotomy. Neurosurg Focus. 2008;24(6):E10.CrossRef
18.
Fang C, Zhu T, Zhang P, Xia L, Sun C. Risk factors of neurosurgical site infection after craniotomy: a systematic review and meta-analysis. Am J Infect Control. 2017;45(11):e123–34.CrossRef
19.
McCutcheon BA, Ubl DS, Babu M, et al. Predictors of surgical site infection following craniotomy for intracranial neoplasms: an analysis of prospectively collected data in the American College of Surgeons National Surgical Quality Improvement Program Database. World Neurosurg. 2016;88:350–8.CrossRef
20.
Ackerman PD, Spencer DA, Prabhu VC. The efficacy and safety of preoperative lumbar drain placement in anterior skull base surgery. J Neurol Surg Rep. 2013;74(1):1–9.CrossRef
21.
Scheithauer S, Burgel U, Bickenbach J, et al. External ventricular and lumbar drainage-associated meningoventriculitis: prospective analysis of time-dependent infection rates and risk factor analysis. Infection. 2010;38(3):205–9.CrossRef
22.
Cain RB, Patel NP, Hoxworth JM, Lal D. Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery. Laryngoscope. 2013;123(11):2633–8.CrossRef
23.
Samadani U, Huang JH, Baranov D, Zager EL, Grady MS. Intracranial hypotension after intraoperative lumbar cerebrospinal fluid drainage. Neurosurgery. 2003;52(1):148–51 discussion 151-2.
24.
Ransom ER, Palmer JN, Kennedy DW, Chiu AG. Assessing risk/benefit of lumbar drain use for endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2011;1(3):173–7.CrossRef
25.
Kim YS, Kim SH, Jung SH, Kim TS, Joo SP. Brain stem herniation secondary to cerebrospinal fluid drainage in ruptured aneurysm surgery: a case report. Springerplus. 2016;5:247.CrossRef
Metadata
Title
The effect of postoperative early lumbar drainage on delayed fever after cerebellopontine angle tumour surgery: study protocol for a randomized controlled trial
Authors
Yunze Zhang
Yingxi Wu
Yang Wu
Gang Zhu
Yafei Xue
Yan Qu
Tianzhi Zhao
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06950-1

Other articles of this Issue 1/2022

Trials 1/2022 Go to the issue

Study protocol

Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY disease (CLARITY): statistical analysis plan for a randomised controlled Bayesian adaptive sample size trial

Update

Brief Educational Video plus Telecare to Enhance Recovery for Older Emergency Department Patients with Acute Musculoskeletal Pain: an update to the study protocol for a randomized controlled trial

Study protocol

Impact of rapid molecular testing on diagnosis, treatment and management of community-acquired pneumonia in Norway: a pragmatic randomised controlled trial (CAPNOR)

Methodology

WILL (When to Induce Labour to Limit risk in pregnancy hypertension): a multicentre randomised controlled trial — adaptations to deliver a timing-of-birth trial during the COVID-19 international pandemic

Study protocol

Acupuncture for prostatectomy incontinence: study protocol for a multicenter single-blind randomized parallel controlled trial

Study protocol

Resources for Enhancing Alzheimer’s Caregiver Health in Vietnam (REACH VN): study protocol for a cluster randomized controlled trial to test the efficacy of a family dementia caregiver intervention in Vietnam