Craneotomia con paciente despierto para resección de tumores cerebrales

Awake craniotomy: A Sleep-AwakeAsleep Craniotomy Clinical Case Study

“…According to Harvey-Jumper published in 2015 having followed up on 27 years of experience on resection of gliomas with patients under the asleep-awake-asleep technique which he records 248 surgeries from 1986 -1997 adding 611 surgeries from 1997-2014 with results of 55% high grade and 42% low risk gliomas, 2% with metastasis and 1% with other lesions found with overall few complications and differences between patients with high risk and low risk gliomas [5]. In 2019 an article published by Gerritsen Jkw, in which he performed 37 asleep-awake-asleep craniotomies and 111 craniotomies under general anaesthesia demonstrating fewer complications in patients intervened with the asleepawake-asleep versus general anaesthesia craniotomies.…”

“…The procedure is performed under microscopic view with functional cerebral tests done in real time searching for evident damage to the cortical and sub cortical areas [5]. to finalize the procedure the laryngeal mask is removed, patient follows awake to the Intensive Care Unit (ICU) having constant evaluation posterior to surgical procedure.…”

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“…Preoperative psychology counseling is required, anxiolytics with alleviated anxiety which Zolpidem is recommended the previous night of the surgical procedure, if necessary at the time of the procedure the patient should be positioned in supine o lateral. To apply a central venous catheter, Foley or urinary catheter, endotracheal intubation or laryngeal mask the patient must be under general Under general anesthesia and a regional scalp block are utilized to block the auricular-temporal nerve, zygomatic-temporal, supraorbital, supra-trochlear and mayor and minor occipital nerve with 0.5% bupivacaine to perform craniotomy [3]. During the surgical procedure stimulation must be applied with a bipolar and uni cautery in two different points.…”