Abstract

Background: Chronic subdural (CSDH) may happen after several day or week after mild to moderate head trauma, especially old age population. Usually, the procedure was done under general anesthesia, the procedure should be done by under local anesthesia due to several lesion. We routinely performed burr hole drainage under local anesthesia and report its benefits.

Methods: We retrospective review 173 patients with CSDH operated by burr hole under local anesthesia from March 2010 to February 2018.

Result: The age range was from 20 to 90 years with mean age of 66.5 years. There were 122 (70.5%) males and 51 (29.5%) females. There were 95 (54.9%) of patients who had the right side, 65 (37.6%) in the left side, and 25 (14.5%) in bilateral CSDH. Radiologic follow-up showed removal of the CSDH in all cases with minimum residual in the early postoperative period and complete resolution at late follow-up. All patients were showed good clinical outcomes comparing preoperative period. post-op hospital stay day was 4.5 days (range 3-8). No patient required revision and no acute hematoma. There was no significant adverse event, during and after operation due to local anesthesia.

Conclusion: Chronic subdural hematoma could be removed by local anesthesia. The intraoperative pain could be well controlled by local anesthesia. We think that awake burr hole drainage under local anesthesia might be shortened hospital stay and prevent the complications of general endotracheal anesthesia, especially old or poor general condition patient.