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Anesthesia for awake craniotomy: a retrospective study.

Prabhat Kumar Sinha1, Thomas Koshy, P Gayatri

  • 1Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. pksinha02@yahoo.com

Neurology India
|November 28, 2007
PubMed
Summary
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Awake craniotomy is a safe procedure utilizing Fentanyl and Propofol for conscious sedation. Advanced monitoring, like Bispectral Index (BIS), may reduce anesthetic use and complications.

Area of Science:

  • Neurosurgery
  • Anesthesiology

Background:

  • Awake craniotomy procedures are increasingly common globally.
  • This study details the anesthetic protocol and outcomes at a university teaching hospital.

Purpose of the Study:

  • To evaluate anesthesia records of patients undergoing awake craniotomy.
  • Analyze the safety and efficacy of the established anesthetic protocol.

Main Methods:

  • Retrospective review of 42 consecutive awake craniotomy cases.
  • Conscious sedation with Fentanyl and Propofol, titrated with Bispectral Index (BIS) monitoring in 16 patients.
  • Scalp blocks and prophylactic antiemetics/antipsychotics were administered.

Main Results:

  • All procedures were completed successfully.

Related Experiment Videos

  • The use of BIS monitoring showed a trend towards reduced anesthetic use and complications.
  • Intraoperative and postoperative complications included hypertension, seizures, and postoperative nausea and vomiting (PONV).

    • Conclusions:

    • Awake craniotomy, with modern monitoring and anesthetic agents, is a relatively safe procedure.
    • The observed complication rate is acceptable for this surgical approach.