The experience of patients undergoing awake craniotomy: in the patients' own words. A qualitative study

Intraoperative mapping is a well-established and safe technique to maximize the excision of tumors involving the eloquent cortex while minimizing neurological damage. Although different techniques are used, very little has been documented about how the patients feel, what they think about, or how they approach this type of surgery without an anesthetic. Considering the inconsistency of literature, a phenomenology study was conducted with the purpose to describe the human experience of patients before, during, and immediately after awake craniotomy. Twenty-one patients were interviewed at length, both the evening before and the evening after surgery. Awake craniotomy is a complex and subjective experience, the behavioral patterns of the subjects interviewed can be attributed to the instinct of self-preservation, the ability to participate during the procedure helping the surgeon in avoiding brain damage; to be in control of the situation; and to reassure themselves and others. It is most important for a healthcare team to understand the patients' experiences. Immediately before and after surgery, the patients seem to concentrate more on keeping their emotions in check and focus on the risk of subsequent defect or disability, rather than on the brain cancer and what it may imply on life. During the surgery, they become particularly involved in the task: they feel directly responsible for the results of surgery relating this to the effectiveness of collaboration with the neurosurgeons.