Is a wake-up call in order? Review of the evidence for awake craniotomy

Paldor, Iddo; Drummond, Katharine J.; Awad, Mohammed; Sufaro, Yuval; Kaye, Andrew H.

doi:10.1016/j.jocn.2015.11.004

Cited by 23 publications

(10 citation statements)

References 48 publications

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“…Local anesthesia would not be sufficient in tumor resection that requires extensive craniotomy. In some cases, the patients were sedated with propofol and fentanyl, and awakened during the mapping (9)(10)(11)13,17,18,23,26,27,29). Propofol provides short-acting sedation without affecting the cognitive functions.…”

Section: █ Conclusionmentioning

confidence: 99%

Awake craniotomy procedure: its effects on neurological morbidity and recommendations

Akay

İşlekel²

2017

Turkish Neurosurgery

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Section: █ Conclusionmentioning

confidence: 99%

Awake craniotomy procedure: its effects on neurological morbidity and recommendations

Akay

İşlekel²

2017

Turkish Neurosurgery

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“…Among the published protocols, patients are uniformly awake during the second phase of the procedure to allow for interactions with the interdisciplinary team. Published protocols differ in anesthetic strategies applied during the first phase and the last phase of an awake craniotomy, with two types of protocols being the most well-known [21]. The ''asleep-awake-asleep" protocol calls for the placement of the patient under general anesthesia with a supported airway during the first phase, has the patient awaken with removal of the supported airway in order to attend to functional testing during the second phase, and then has the patient reanesthetized with an re-established airway during the final phase [9,11,14,23].…”

Section: Introductionmentioning

confidence: 99%

The Stony Brook awake craniotomy protocol: A technical note

Shen

Calandra

Geralemou

et al. 2019

Journal of Clinical Neuroscience

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Most current awake craniotomy techniques utilize unnecessarily complicated airway management, and cause discomfort to the patients during the awake phase of the surgery. Our manuscript is written to discuss the neurosurgical and anesthetic techniques that we have developed to optimize awake craniotomy techniques at Stony Brook University Medical Center. We used the frameless Brainlab TM skull-mounted array for stereotactic navigation. Rigid fixation of the skull was avoided. General anesthesia with established airway was used during the ''asleep" phase of the surgery. Following the removal of the bone flap and the opening of the dura, the patients were woken up, and the established airway was removed. Cortical mapping was performed to establish a safe entry zone for tumor removal. While the tumors were being removed, we continued motor examination and casual conversation with the patients to ensure safety. Patients were sedated during the remaining phase of the surgery until skin closure. No patient exhibited any neurological deficits or adverse anesthesia outcomes during the postoperative period. The protocol we developed avoids rigid skull fixation and emphasizes flexible intraoperative planning, thereby maximizing patient and physician comfort while allowing for successful tumor resection.

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“…Previous studies have demonstrated that it can decrease the postoperative neurological deficit and increase the volume of lesion resection. 1,2 This procedure is indicated for intrinsic brain lesions, especially for gliomas (both low and high grades) and metastasis. 2 However, the success of this operation requires appropriate patient selection, preparation, a specialized anesthetic technique, adequate intraoperative testing, and monitoring.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 This procedure is indicated for intrinsic brain lesions, especially for gliomas (both low and high grades) and metastasis. 2 However, the success of this operation requires appropriate patient selection, preparation, a specialized anesthetic technique, adequate intraoperative testing, and monitoring. 3 We report the first case of awake craniotomy at our institute in June 2017.…”

Section: Introductionmentioning

confidence: 99%

The First Awake Craniotomy for Eloquent Glioblastoma in Southern Thailand

Kaewborisutsakul

Saeheng

Kitsiripant

et al. 2019

J Health Sci Med Res

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Awake craniotomy (AC) with direct cortical stimulation is becoming the gold standard for functional brain mapping. It is used to identify the safe brain area before pathologic resection. This method indicates the pathology near or at the eloquent cortex, such as gliomas or metastasis. AC can optimize the patient’s quality of life and oncologic outcome. This task requires the active cooperation of a patient care team familiar with advanced neuroscience and challenging to learn. We report the first time this operation which performed in our institute with technical details, in terms of anesthesia, and surgical aspects.

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Is a wake-up call in order? Review of the evidence for awake craniotomy

Cited by 23 publications

References 48 publications

Awake craniotomy procedure: its effects on neurological morbidity and recommendations

Awake craniotomy procedure: its effects on neurological morbidity and recommendations

The Stony Brook awake craniotomy protocol: A technical note

The First Awake Craniotomy for Eloquent Glioblastoma in Southern Thailand

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