Resection of brain tumours carries a great risk of functional impairment, especially if the tumour is located in the anterior temporal or frontal lobes, near motor, language, or memory areas of the brain. Awake craniotomy has been proposed aiming for maximum resection with minimum impairment of neurological function. The technique should provide adequate sedation, analgesia, respiratory and haemodynamic stability with an awake and cooperative patient for neurological testing. Airway management during a wake craniotomy is a crucial part of the anaesthetic technique, but it remains the subject of debate. In this case, who was the first patient operated upon as awake craniotomy in Sudan; awake craniotomy has been adopted as his cardiac function made surgery under general anaethesia a potential risk. The patient's tolerance to the procedure, haemodynamic stability, the incidence of airway obstruction and intraoperative and postoperative neurological status were assessed. The candidate well tolerated the procedure, with haemodynamic stability and a patent airway throughout the procedure. Convenient resection of the tumor was achieved and uneventful post-operative recovery with no neurological deficits was reported.
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