Designing an operating theatre for awake procedures: A solution to improve multimodality information input

<i>Objective</i>. Many neurosurgical procedures are now performed with the patient aware in order to allow interactions between the patient and healthcare professionals. These procedures include awake brain surgery and spinal cord stimulation (SCS), lead placement for treatment of refractory chronic back and leg pain. Neurosurgical procedures under local anaesthesia require optimal intraoperative cooperation of the patient and all personnel involved in surgery. In addition to accommodating this extra source of intraoperative information all other necessary sources of data relevant to the procedure must be presented. The concept of an operating room dedicated to neurosurgical procedures performed aware and accommodating these concepts is presented, and some evidence for improvements in outcome presented, deriving from a series of patients implanted with spinal cord stimulators before and after the operating theatre was brought into service. <i>Results and discussion</i>. In addition to the description, two videos demonstrate the facility online. Beyond this qualitative evidence, quantitative improvement in patient outcome is evidenced by the series presented: 91.3% of patients operated in the awake anaesthesia-dedicated theatre obtained adequate low back pain coverage, versus 60.0% for patients operated before (p = 0.028). <i>Conclusion</i>. The concept of such an operating room is a step in improving the outcome by improving the presentation of all types of information to the operating room staff most notably in the example of aware procedures.

<i>研究目的</i>。目前诸多神经外科手术会在患者保持清醒的状态下开展，以实现患者与医护人员之间的互动配合。此类手术包括清醒开颅术，以及用于治疗难治性慢性腰腿痛的脊髓神经刺激（spinal cord stimulation, SCS）电极植入术。局部麻醉下的神经外科手术需要患者与所有手术相关人员在术中实现最优协作。除了适配这类额外的术中信息交互需求外，还需向手术团队呈现与手术相关的所有其他必要数据。本文提出了一种专为清醒状态下神经外科手术设计、并适配上述协作与数据呈现理念的专用手术室方案；同时结合该手术室启用前后接受脊髓神经刺激器植入术的一系列患者数据，展示了该方案可改善手术结局的相关证据。<i>结果与讨论</i>。除上述方案描述外，另有两段视频在线展示该专用手术室的设施细节。除上述定性证据外，本次纳入的患者队列还证实了手术结局的量化改善：在该专用清醒麻醉手术室完成手术的患者中，91.3%获得了满意的腰痛症状控制，而该手术室启用前接受手术的患者这一比例仅为60.0%（p=0.028）。<i>结论</i>。此类专用清醒手术手术室的理念，通过为手术室医护人员更全面地呈现各类手术相关信息，可有效改善手术结局，在清醒状态下开展的手术中这一优势尤为显著。