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Perioperative Management of Adult Patients With External Ventricular and Lumbar Drains: Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care

Lele, Abhijit V. MBBS, MD, MS*; Hoefnagel, Amie L. MD; Schloemerkemper, Nina MD, Dr. med., FRCA; Wyler, David A. MD§; Chaikittisilpa, Nophanan MD; Vavilala, Monica S. MD; Naik, Bhiken I. MBBCh#; Williams, James H. MD, PhD**; Venkat Raghavan, Lakshmikumar MBBS, MD, FRCA, FRCPC††; Koerner, Ines P. MD, PhD‡‡; Representing SNACC Task Force for Developing Guidelines for Perioperative Management of External Ventricular and Lumbar Drains

Journal of Neurosurgical Anesthesiology: July 2017 - Volume 29 - Issue 3 - p 191–210
doi: 10.1097/ANA.0000000000000407
Special Article

External ventricular drains and lumbar drains are commonly used to divert cerebrospinal fluid and to measure cerebrospinal fluid pressure. Although commonly encountered in the perioperative setting and critical for the care of neurosurgical patients, there are no guidelines regarding their management in the perioperative period. To address this gap in the literature, The Society for Neuroscience in Anesthesiology & Critical Care tasked an expert group to generate evidence-based guidelines. The document generated targets clinicians involved in perioperative care of patients with indwelling external ventricular and lumbar drains.

Departments of *Anesthesiology & Pain Medicine, Neurocritical Care Service

Anesthesiology and Pain Medicine

Anesthesiology and Pediatrics, Harborview Injury Prevention and Research Center (HIPRC), Harborview Medical Center, University of Washington, Seattle, WA

Department of Anesthesiology, University of Florida, UF Health, Jacksonville, FL

Department of Anesthesiology & Pain Medicine, University of California Davis Medical Center, Sacramento, CA

§Jefferson Hospital of Neuroscience, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA

#Department of Anesthesiology & Neurosurgery, University of Virginia Health System, Charlottesville, VA

**Department of Anesthesiology, University of North Carolina at Chapel Hill, N2201 UNC Hospitals, Chapel Hill, NC

††Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada

‡‡Department of Anesthesiology & Perioperative Medicine, Neurosciences ICU, Oregon Health Sciences University, Portland, OR

A.V.L.: manuscript design, manuscript write-up, Tables 1 to 6, Figures 1A, 1B, 2A, 2B, Sections 1 to 6, developing clinical competencies for EVD/LD among clinicians involved in perioperative care, continued medical education and following a perioperative checklist for management of EVD/LD, review and approve final manuscript. A.L.H. and N.S: manuscript write-up, Section 1: Introduction, indications and contraindications, review and final approve manuscript. D.A.W.: manuscript write-up, Section 2: Preoperative assessment of patients with EVD or LD, review and approve final manuscript. N.C. and M.S.V.: manuscript write-up, Section 3: Transporting patients with EVD or LD, review and approve final manuscript. B.I.N. and J.H.W.: manuscript write-up, Section 4: Intraoperative management of external ventricular and lumbar drains, review and approve final manuscript. L.V.R. and I.P.K.: manuscript write-up, Section 5: Management of external ventricular drains (EVD)/lumbar drains (LD) in special clinical scenarios, review and approve final manuscript.

A.L.H. has received honoraria from Design Science Consulting Inc.; N.S. has received consulting fee from Mizuho OSI. The other authors have no conflicts of interest to disclose.

Address correspondence to: Abhijit V. Lele, MBBS, MD, MS, Department of Anesthesiology & Pain Medicine, Neurocritical Care Service, Harborview Medical Center, University of Washington, 325, 9th Avenue, Seattle, WA 98104 (e-mail: abhijit2@uw.edu).

Received December 22, 2016

Accepted December 27, 2016

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