Awake craniotomy

Potters, Jan-Willem; Klimek, Markus

doi:10.1097/aco.0000000000000231

Cited by 46 publications

(20 citation statements)

References 48 publications

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“…An appropriate way to address this is to identify the individual level of development and the correlated suitability of the child preoperatively [ 16 ]. The extent and quality of preoperative mental and psychological preparation have an impact on the psychological experience and correlate with the neuropsychological outcome [ 7 , 17 , 20 , 21 ], following awake brain surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The tasks to be performed during brain mapping are also typically explained and rehearsed preoperatively [ 22 ]. Qualitative studies regarding patients' perceptions and experience of an awake craniotomy along with their satisfaction with the procedure correlate well with their preoperative preparation and trust in the surgical team [ 23 – 25 ].The extent and quality of preoperative mental and psychological preparation have a direct impact on the psychological experience and correlate with the neuropsychological outcome [ 7 , 17 , 20 , 21 ],following awake brain surgery. “Adequate patient preparation appears to have a protective effect” [ 20 ] from psychological sequelae of an awake craniotomy.…”

Section: Discussionmentioning

confidence: 99%

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Awake Craniotomy in a Child: Assessment of Eligibility with a Simulated Theatre Experience

Labuschagne

Lee

Mutyaba

et al. 2020

Case Reports in Anesthesiology

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Background. Awake craniotomy is a useful surgical approach to identify and preserve eloquent areas during tumour resection, during surgery for arteriovenous malformation resections and for resective epilepsy surgery. With decreasing age, a child’s ability to cooperate and mange an awake craniotomy becomes increasingly relevant. Preoperative screening is essential to identify the child who can undergo the procedure safely. Case Description. A 11-year-old female patient presented with a tumour in her right motor cortex, presumed to be a dysembryoplastic neuroepithelial tumour (DNET). We had concerns regarding the feasibility of performing awake surgery in this patient as psychological testing revealed easy distractibility and an inability to follow commands repetitively. We devised a simulated surgical experience to assess her ability to manage such a procedure. During the simulated theatre experience, attempts were made to replicate the actual theatre experience as closely as possible. The patient was dressed in theatre attire and brought into the theatre on a theatre trolley. She was then transferred onto the theatre bed and positioned in the same manner as she would be for the actual surgery. Her head was placed on a horseshoe headrest, and she was made to lie in a semilateral position, as required for the surgery. A blood pressure cuff, pulse oximeter, nasal cannula with oxygen flow, and calf pumps were applied. She was then draped precisely as she would have been for the procedure. Theatre lighting was set as it would be for the surgical case. The application of the monitoring devices, nasal cannula, and draping was meant not only to prepare her for the procedure but to induce a mild degree of stress such that we could assess the child’s coping skills and ability to undergo the procedure. The child performed well throughout the simulated run, and surgery was thus offered. An asleep-awake-asleep technique was planned and employed for surgical removal of the tumour. Cortical and subcortical mapping was used to identify the eloquent tissue. Throughout the procedure, the child was cooperative and anxiety free. Follow-up MRI revealed gross total removal of the lesion. Conclusion. A simulated theatre experience allowed us to accurately determine that this young patient, despite relative contraindications, was indeed eligible for awake surgery. We will continue to use this technique for all our young patients in assessing their eligibility for these procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Awake Craniotomy in a Child: Assessment of Eligibility with a Simulated Theatre Experience

Labuschagne

Lee

Mutyaba

et al. 2020

Case Reports in Anesthesiology

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“…Control of preoperative anxiety before awake craniotomy is important and can be relieved by proper preoperative counseling about the anesthetic and surgical procedures. Therefore, preoperative consultation by anesthesiologist is an important process [ 14 , 15 ]. The anesthesiologist should outline the overall awake craniotomy procedures including the positioning, scalp nerve block, the possible discomfort, and the motor and language test.…”

Section: Preoperative Preparationmentioning

confidence: 99%

Anesthetic considerations for awake craniotomy

Kim

Choi

2020

Anesth Pain Med

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Awake craniotomy is a gold standard of care for resection of brain tumors located within or close to the eloquent areas. Both asleep-awake-asleep technique and monitored anesthesia care have been used effectively for awake craniotomy and the choice of optimal anesthetic approach is primarily based on the preferences of the anesthesiologist and surgical team. Propofol, remifentanil, dexmedetomidine, and scalp nerve block provide the reliable conditions for intraoperative brain mapping. Appropriate patient selection, adequate perioperative psychological support, and proper anesthetic management for individual patients in each stage of surgery are crucial for procedural safety, success, and patient satisfaction.

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“…J.-W. Roberts и M. Klimek опубликовали обзор, посвященный именно оптимизации ощущений оперируемого пациента во время КС [31]. Что особенно интересно в этой работе, так это то, что авторы сконцентрировали внимание на психологических методах подготовки и ведении пациентов с КС, лишь кратко коснувшись фармакологических методов.…”

Section: почему вообще воз никли опасения в отношении эмоциональных пunclassified

Sensations of patients and their satisfaction during awake craniotomy

Lubnin¹,

Sinbukhova²,

Kulikov³

et al. 2020

Vopr. neirokhir.

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Резюме Методика краниотомии в сознании (КС) за последние годы приобрела фантастическую распространенность и теперь уже не является уделом только высокоспециализированных нейрохирургических центров. Методологическая сторона КС разработана достаточно полно, чего нельзя сказать о таком аспекте, как исследование ощущений оперируемых пациентов и их общей удовлетворенност и. Анализу этой стороны проблемы и посвящен приводимый обзор литературы, в котором показано, что процедура КС положительно оценивается подавляющим большинством пациентов. Многие из них выбрали бы эту методику при повторных вмешательствах. Однако есть ряд клинически важных деталей, которые могут негативно влиять на общую удовлетворенность пациента КС, и их следует учитывать. Ключевые слова: краниотомия в сознании, ощущения пациентов, общая удовлетворенность анестезией и операцией.

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Awake craniotomy

Cited by 46 publications

References 48 publications

Awake Craniotomy in a Child: Assessment of Eligibility with a Simulated Theatre Experience

Awake Craniotomy in a Child: Assessment of Eligibility with a Simulated Theatre Experience

Anesthetic considerations for awake craniotomy

Sensations of patients and their satisfaction during awake craniotomy

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