Anesthesia for awake craniotomy: case report

Bolzani, Nelson Davi; Junqueira, Daisy de Oliveira Pollon; Ferrari, Paulo André Pinheiro Fernandes; Ferrari, Antonio Fernandes; Gaia, Felipe; Tapajós, Caroline Moraes; Moura, José Francisco Cursino de; Neto, Edmundo Pereira de Souza

doi:10.1016/j.bjane.2013.02.003

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Alternatively, Brosnan et al performed an asleep-awake-asleep craniotomy on a non-verbal patient by the use of neuronavigation and 5-aminolevulinic acid fluorescence, and postoperative examination proved an improvement in speech and cognition [ 15 ]. Bolzani et al concluded that although the maintenance of analgesia and hemodynamic stability is a challenge with an awake patient, the target-controlled infusion of anesthetic drugs can provide the needed level of consciousness, which is essential for the satisfactory outcome of the procedure [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Awake Craniotomy for a Frontal Astrocytoma: A Case Report

Velchev,

Burev,

Ferdinandov

et al. 2024

Cureus

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Awake craniotomy is a surgical procedure that has been gaining significance over the past decades.Neuronavigation is an intraoperative technology that locates tumors and monitors the brain cortex during awake craniotomy. The presence of cerebral low-grade gliomas in the frontal lobe creates a risk of affecting vital centers of the brain cortex during surgery. We present a clinical case of a 42-year-old male patient who entered the neurosurgery clinic with a clinical manifestation of headache for two months. MRI showed evidence of the recurrence of a left frontal glioma. Differential diagnoses of frontal gliomas include metastases, abscesses, and cysts. The pathophysiologic background of the disease is the mutation of neuroglial cells, which leads to an abnormal and uncontrollable proliferation. Under sleep-awake anesthesia, operative treatment was performed through left frontal awake craniotomy under neuronavigation. As a result, a total excision was achieved. Motor functions of the right limbs and speech have been preserved. The patient was mobilized on the day after the intervention. Surgery-related complications were not observed. The patient had relief from the symptoms and was discharged on the fifth day. Awake craniotomy combined with neuronavigation was the most efficient and the least harmful method for the excision of the tumor. For low-grade gliomas localized in the frontal area of the encephalon, awake craniotomy is the only secure option for surgery.

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Section: Discussionmentioning

confidence: 99%

Awake Craniotomy for a Frontal Astrocytoma: A Case Report

Velchev,

Burev,

Ferdinandov

et al. 2024

Cureus

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“…The role of the anaesthesiologist is to provide analgosedation and cardiorespiratory stability without interfering with electrophysiological monitoring and cognitive tests, so optimal anaesthetic management remains a challenge [6].…”

Section: Discussionmentioning

confidence: 99%

Anaesthesia for awake brain tumour surgery: Case report

Vicković¹,

Ikonić

Karan

et al. 2016

Med pregl

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“…9,10 The use of sedation scales such as the Ramsay sedation score has helped ensure an appropriate depth of anesthesia throughout the procedure. 11,12 The disadvantages of the procedure identified are as follows: (1) possibility of a prolonged surgical procedure with awkward body positioning; (2) need for patient cooperation to evaluate language, memory, and motor skills; (3) potential for significant patient discomfort, e.g., pain, nausea and recall; and (4) potential for emergent airway management should the patient become uncooperative or when persistent seizure activity occurs. Knowledge of these consequences is the first step in addressing them during the awake phase of the procedure.…”

Section: History Of Awake Craniotomy In the Philippine General Hospitalmentioning

confidence: 99%

Challenges in the Performance of Awake Craniotomies in the Philippine General Hospital: A Case Series

Jose¹,

Legaspi²

2021

Acta Med Philipp

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Awake craniotomy is a neurosurgical technique that involves an awake neurological testing during the resection of an intracranial lesion in eloquent cerebral cortical areas representing motor, language, and speech. This technique is highlighted by an intra-operative cortical mapping that requires active participation by the patient and poses unique challenges to the anesthesiologist. The surgical and anesthetic techniques have evolved significantly over time, as the neurosurgeon and the anesthesiologist learn new steps in making this technique safe to achieve reasonable patient satisfaction. A thorough understanding of this surgical technique's rationale will guide the anesthesiologist in planning the anesthetic management depending on the surgery and neurologic testing. Constant communication between the neurosurgeon, anesthesiologist, and the patient will define this surgical technique's success. It is already a well-established procedure; however, factors that contribute to failures in awake craniotomy procedures have not been well characterized in the literature. Failure is defined as the inability to conduct awake neurologic testing during the awake craniotomy procedure because of various factors which will be described. This paper aims to review the challenges in the performance of three (3) cases of awake craniotomies performed in the Philippine General Hospital. The challenges described in these three (3) cases reveal that this can be experienced by the neurosurgeon, neuroanesthesiologist, and most especially the patient in an acute critical condition. Identification of the procedures' failure and the steps taken to manage such situations with the patient's safety in mind are discussed.

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Anesthesia for awake craniotomy: case report

Cited by 4 publications

References 9 publications

Awake Craniotomy for a Frontal Astrocytoma: A Case Report

Awake Craniotomy for a Frontal Astrocytoma: A Case Report

Anaesthesia for awake brain tumour surgery: Case report

Challenges in the Performance of Awake Craniotomies in the Philippine General Hospital: A Case Series

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