[Use of the lateral approach for laryngeal mask insertion during awake craniotomy: case report.]

During an awake craniotomy in which the Aachen Aphasia test is performed, it is necessary to use the 'asleep-awake-asleep' anesthetic technique. The objective of this case report was to describe the anesthetic technique used in a patient with signs of difficult airway.

The case of a patient who underwent resection of a tumor in the left temporal lobe, in the Wernicke gyrus, with clinical signs of difficult airway is reported. The 'asleep-awake-asleep' anesthetic technique, with continuous infusion of propofol and remifentanil, was used. A laryngeal mask, inserted by the lateral approach, was used to keep the airways patency.

The technique used was effective in obtaining an intraoperative awake and cooperative patient, and the airways were maintained patent with a laryngeal mask. Insertion of this device by the lateral approach is especially interesting since this was a patient who presented difficult airway and underwent a surgical procedure in which in which the patient must remain immobile and the surgical field cannot be contaminated.