Perioperative anesthetic management and postoperative outcomes of patients treated with CyberKnife® robotic radiosurgery

The CyberKnife® is a robotic stereotactic radiosurgery system designed for non-invasive treatment of tumor lesions. Some of these procedures are performed under sedation or general anesthesia, depending on the patient and the lesion being treated. The objective of this study is to describe the anesthetic management and postoperative outcomes of patients treated with CyberKnife® radiosurgery at a reference center for neurosurgery in the city of Medellín, Colombia. A descriptive, retrospective study was conducted on patients treated with CyberKnife® under sedation or general anesthesia between 2012 and 2022. 75 patients were included, 56% of whom were female, with a median age of 59 years, primarily operated on for uveal melanomas (40%) and other tumor pathologies of the central nervous system; most frequently scheduled for a total of 5 radiosurgery sessions (66,7%), on an outpatient basis in 96% of cases. The main anesthetic technique used was balanced general anesthesia (76%) with sevoflurane, propofol, lidocaine, fentanyl. Neuromuscular relaxation was used in 58,7% of patients. Airway management was performed with a laryngeal mask in most cases (64%). The main minor side effects or complications identified were postoperative headache (22,7%), followed by intraoperative hypotension (18,7%) and bradycardia (16%). No major complications associated with anesthetic management were reported. Balanced general anesthesia with neuromuscular relaxation was the main anesthetic technique used for CyberKnife® radiosurgery. Despite the logistical difficulties in this type of procedure, no major complications during the perioperative period were found. El CyberKnife® es un equipo de radiocirugía estereotáxica robótica, diseñado para la intervención no invasiva de lesiones tumorales. Algunos de estos procedimientos se realizan bajo sedación o anestesia general, según el paciente y la lesión a tratar. El objetivo de este estudio es describir el manejo anestésico y desenlaces posquirúrgicos de pacientes tratados con radiocirugía CyberKnife® en un centro de referencia de neurocirugía de la ciudad de Medellín, Colombia. Estudio descriptivo, retrospectivo, de pacientes tratados con CyberKnife® bajo sedación o anestesia general entre 2012 y 2022. Se incluyeron 75 pacientes, 56% de sexo femenino, con una mediana de edad de 59 años, intervenidos principalmente para melanomas uveales (40%) y otras patologías tumorales del sistema nervioso central; programados con mayor frecuencia