Awake Craniotomy: A New Airway Approach

Area of Science:

• Neurosurgery
• Anesthesiology
• Airway Management

Background:

• Awake craniotomies are established procedures requiring careful airway management.
• Current airway management strategies include endotracheal intubation, laryngeal mask airways, facemasks, and nasal cannulas.
• Managing the airway during transitions between sedation and wakefulness presents challenges.

Purpose of the Study:

• To describe the successful use of bilateral nasopharyngeal airways in patients undergoing awake craniotomies.
• To evaluate the efficacy of nasopharyngeal airways in maintaining adequate gas exchange without endotracheal intubation.
• To report any adverse events associated with this airway management technique.

Main Methods:

• A case series of 90 patients undergoing awake craniotomies was reviewed.
• Bilateral nasopharyngeal airways were utilized for airway management throughout the procedure.
• Success was defined as the absence of endotracheal intubation due to inadequate gas exchange.

Main Results:

• Successful airway management was achieved in all 90 patients using bilateral nasopharyngeal airways.
• No patients required endotracheal intubation for inadequate gas exchange.
• The technique facilitated a smooth transition between the asleep and awake phases of anesthesia.

Conclusions:

• Bilateral nasopharyngeal airways represent a viable and effective airway management strategy for awake craniotomies.
• This method avoids airway stimulation associated with endotracheal intubation.
• Further investigation into potential adverse events is warranted.