Inflammatory profile of awake function-controlled craniotomy and craniotomy under general anesthesia
Markus Klimek1, Jaap W Hol, Stephan Wens
1Department of Anesthesiology, Erasmus MC, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands. m.klimek@erasmusmc.nl
Mediators of Inflammation
|June 19, 2009
Summary
Awake craniotomy and general anesthesia craniotomy show similar inflammatory responses. Awake surgery may lead to less postoperative pain, with comparable stress and anxiety levels in both groups.
Area of Science:
- Neurosurgery
- Anesthesiology
- Immunology
Background:
- Surgical stress induces an inflammatory response, releasing plasma mediators like interleukins (ILs).
- Craniotomy under general anesthesia versus awake craniotomy may elicit different stress and inflammatory responses.
Purpose of the Study:
- To compare the inflammatory responses between awake function-controlled craniotomy and craniotomy under general anesthesia.
- To assess differences in pain, anxiety, and stress levels between the two surgical approaches.
Main Methods:
- A prospective, observational study included 20 patients in each group: general anesthesia craniotomy and awake function-controlled craniotomy.
- Circulating levels of IL-6, IL-8, and IL-10 were measured pre-, peri-, and postoperatively.
- Visual Analog Scale (VAS) scores for pain, anxiety, and stress were recorded at multiple time points.
Main Results:
- Plasma IL-6 levels increased similarly over time in both groups.
- No significant changes in plasma IL-8 and IL-10 were observed.
- The awake group reported significantly lower VAS pain scores at 12 hours postoperatively, with similar declines in anxiety and stress for both groups.
Conclusions:
- Awake function-controlled craniotomy does not appear to induce a significantly different inflammatory response compared to general anesthesia craniotomy.
- Function-controlled craniotomy is unlikely to pose a greater emotional challenge than tumor resection under general anesthesia.
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