A Systematic Review of Medical and Nursing Care for Patients with Neurological Diseases, Focusing on the Pre and Post-Operative Considerations

Introduction: This systematic review aims to synthesize evidence regarding medical and nursing care for patients with neurological diseases undergoing surgery, with a focus on pre- and post-operative considerations. This review underscores the need for standardized protocols that integrate medical and nursing perspectives in perioperative neurological care. While substantial progress has been made, gaps remain in consistent implementation of evidence-based practices and patient-centered approaches. Future research should focus on developing integrated care models and evaluating their effectiveness in enhancing surgical outcomes for patients with neurological diseases. Methodology: Following PRISMA-based methodology, key areas include preoperative assessment, risk optimization, perioperative medication management, anesthetic strategies, and post-operative bundles of care such as hemodynamic control, secondary brain injury prevention, venous thromboembolism (VTE) prophylaxis, infection prevention, nutrition, pain management, early rehabilitation, and patient/family education. Findings: Findings indicate that pre-operative considerations should prioritize accurate neurological assessment, optimization of comorbidities, psychological support, and patient education to enhance compliance and reduce anxiety. Pre-operative imaging, medication management (e.g., anticonvulsants, anticoagulants), and nutritional status evaluation were also identified as critical. Intraoperative nursing care, though less frequently studied, emphasizes the importance of hemodynamic stability, intracranial pressure monitoring, and prevention of complications such as hypoxia and infection. Conclusion: Optimal perioperative care for neurosurgical patients requires a standardized, multidisciplinary, and nursing-centered approach. Critical elements include risk assessment, medication management, neuro-focused anesthesia and monitoring, structured post-op neurological checks, complication prevention, multimodal analgesia, nutrition/dysphagia management, early rehabilitation, and robust patient/family education. Adoption of ERAS pathways and quality monitoring can significantly improve outcomes and reduce healthcare costs.