Anesthesia for Awake Craniotomy: What Is New?

Jangra, Kiran; Rath, Girija Prasad

doi:10.1007/s40140-018-0285-2

Cited by 3 publications

(7 citation statements)

References 58 publications

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“…Schucht et al [28] in their series of 8 pediatric patients with 4 preadolescents found that the quantitative mapping thresholds for assessing the risk of direct damage to the motor cortex were similar to the established values found in adults [26]. Thus, the recent modifications in the technique of mapping and monitoring strategies in preadolescents have established it as reliable and safe as in adults [4, 25, 29, 30].…”

Section: Discussionmentioning

confidence: 92%

Technical Considerations in Awake Craniotomy with Cortical and Subcortical Motor Mapping in Preadolescents: Pushing the Envelope

Ratha¹,

Sampath²,

Subramaniam

et al. 2021

Pediatr Neurosurg

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Introduction: Unlike adult gliomas, the utility of combined application of awake anesthesia and intraoperative neurophysiological monitoring (IONM) for maximal safe resection in eloquent region gliomas (ERG) has not been established for pediatric population while it remains unexplored in preadolescents (below 11 years old). Case Presentation: We report 2 cases of awake craniotomy with IONM in an 8 and 9 year old for safe maximal resection of ERG. In both the cases, repeated preoperative visits of the operating room was performed to familiarize and educate the children about intraoperative communication, comfortable positioning, and neurological assessment. Under conscious sedation protocol, cortical and subcortical mapping, and electrocorticography, gross total resection was achieved. In both the cases, there were no postoperative neurodeficits or perioperative complications. Conclusion: Our 2 cases illustrate the first instance of successful use of awake IONM for maximal safe resection of ERG in preadolescent age-group. We believe, with proper preoperative planning and careful titration of anesthetics, it is safe and feasible. The blanket notion that preadolescent age-group should be excluded from awake mapping needs to be challenged, rather curated on a case basis.

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Section: Discussionmentioning

confidence: 92%

Technical Considerations in Awake Craniotomy with Cortical and Subcortical Motor Mapping in Preadolescents: Pushing the Envelope

Ratha¹,

Sampath²,

Subramaniam

et al. 2021

Pediatr Neurosurg

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“…Previously, maximum volumes of 40 to 60 mL of lignocaine with adrenaline and bupivacaine have been used for giving this block. 8 For abdominal bone flap retrieval, we administered ultrasound-guided oblique TAP block, wherein the drug is administered along the oblique subcostal line, in the plane above the transverse abdominis muscle, starting from the xiphoid process, approaching the anterior part of iliac crest (►Figs. 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, maximum volumes of 40 to 60 mL of lignocaine with adrenaline and bupivacaine have been used for giving this block. 8…”

Section: Discussionmentioning

confidence: 99%

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Awake Cranioplasty in a Patient with Rheumatic Heart Disease: A Novel Approach

Depuru

Bhatia

Bhagat

et al. 2022

J Neuroanaesth Crit Care

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Cranioplasty is a surgical procedure that restores the normal anatomy following craniectomy. Restoring the skull bone ensures protection and normalizes the physiology as well as the cerebrospinal fluid dynamics. This surgical procedure usually requires administration of general anesthesia for retrieving the bone placed in the abdominal region and thereafter placing it in the cranium. We report the anesthetic management of a high-risk case who had severe mitral stenosis and was scheduled for cranioplasty. The anesthetic management of a patient with rheumatic heart disease, with severe mitral stenosis, posted for cranioplasty, is extremely challenging. The presence of cardiac pathology necessitates the need to balance patient's hemodynamics in accordance with the cardiac grid and tests the limits of the anesthesiologist's preparedness. We describe our experience of conduct of this case in regional anesthesia using scalp block on the defect site with an oblique transverse abdominis plane block for abdominal bone retrieval.

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“…We must be prepared for potential intraoperative complications too. 6 As antiepileptics have potential teratogenic effects, the drugs with minimal fetal effects should be chosen. For intraoperative seizures, the management line includes ice cold saline instillation in the surgical field followed by propofol boluses; if not controlled, midazolam and levetiracetam should be used.…”

mentioning

confidence: 99%

Awake Craniotomy in a Pregnant Patient—A Unique Challenge

Kaur,

Singh,

Jangra

et al. 2023

J Neuroanaesth Crit Care

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Anesthesia for Awake Craniotomy: What Is New?

Cited by 3 publications

References 58 publications

Technical Considerations in Awake Craniotomy with Cortical and Subcortical Motor Mapping in Preadolescents: Pushing the Envelope

Technical Considerations in Awake Craniotomy with Cortical and Subcortical Motor Mapping in Preadolescents: Pushing the Envelope

Awake Cranioplasty in a Patient with Rheumatic Heart Disease: A Novel Approach

Awake Craniotomy in a Pregnant Patient—A Unique Challenge

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