Anesthesia Comlications After Neurosurgical Procedure in Post-Anesthesia Care Unit Running Title: Complications in Post-Anesthesia Care Unit

Background: Complications in anesthesia emergence after neurosurgery varies widely but is associated with negative neurological outcomes. The present study was to investigate postoperative complication in the PACU. Methods: During July 2015 to July 2016, the retrospective cohort study was conducted and 1586 adult patients who underwent selective neurological surgery in West China Hospital, Sichuan University, were recruited. The complications, including hypertension, hypoxia, etc. were determined by an anesthetist in PACU. Univariate statistics were performed using the chi-squared test, and 95% confidence intervals were determined for the resultant risk ratios. A multivariate model was constructed using significant variables from the univariate analysis (p < 0.05) with binary logistic regression. Results: Among the involved 1586 patients, the most frequent complications were hypertension (21.5% of patients) and hypoxemia (7.25% of patients), followed by airway obstruction (6.87%). Top three surgery for hypertension incidence were surgery for trigeminal neuralgia, aneurysm, subtentorial lesions. Significant predictors of hypertension included advanced age, sex, preoperative hypertension, and duration of general anesthesia. Conclusions: In the period of anesthesia recovery of neurosurgical patients, hypertension, hypoxemia, airway obstruction are three main complications in PACU.