EARLY postoperative extubation following elective neurosurgical treatment of brain metastases appears safe and does not increase the risk of complications or re-intubation, according to findings from a single-center cohort study.
Researchers retrospectively analyzed outcomes from 190 patients who underwent intracranial surgery for brain metastases between 2018 and 2020. Patients were categorized into two groups: those extubated early in the recovery room (34.2%) and those who received delayed extubation in the intensive care unit (65.8%). The study assessed a range of clinical variables including ASA status, intraoperative blood loss, comorbidities, adverse events, surgical complications, and hospital length of stay.
No significant differences were identified between the early and delayed extubation groups in terms of postoperative complications. While the delayed extubation group had higher transfusion requirements, this was the only statistically significant variable in the univariate analysis (p = 0.037). Although adverse events were more frequent in the delayed extubation group, this difference did not reach statistical significance in the multivariate analysis.
The findings support the clinical feasibility and safety of early extubation in appropriately selected patients undergoing elective neurosurgical resection of brain metastases. Importantly, no increased risk of immediate postoperative re-intubation was observed in patients extubated early.
These results may offer reassurance to clinicians weighing the risks of extubation timing in neurosurgical recovery, particularly in the context of resource allocation and infection control in the intensive care unit.
Reference:
Khalafov L et al. Early versus delayed postoperative extubation after elective neurosurgical treatment of brain metastasis. J Cancer Res Clin Oncol. 2025;151(8):226.
