Related Experiment Video
Updated: Mar 4, 2026

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat
Published on: August 28, 2021
Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil
Andrea Prontera1, Stefano Baroni2, Andrea Marudi2
1Department of Neurosurgery, Nuovo Ospedale Civile SAgostino-Estense.
Introduction:
Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing.
Methods:
Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management.
Results:
The anesthetic protocol applied in our study has the advantage of decreasing the dose of each drug and thus reducing the occurrence of side effects. All patients had smooth and rapid awakenings. The brain remained relaxed during the entire procedure.
Conclusion:
In our experience, this protocol is safe and effective during awake brain surgery. Nevertheless, prospective randomized trials are necessary to confirm the optimal anesthetic technique to be used.
More Related Videos
Related Concept Videos
Parenteral Anesthetics: Overview
Stages of General Anesthesia
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Inhalational Anesthetics: Overview
Depolarizing Blockers: Pharmocokinetics

