Anaesthesiologist's Approach to Awake Craniotomy

Area of Science:

• Neurosurgery
• Anesthesiology
• Neurology

Background:

• Awake craniotomy, initially for epilepsy, is now used for brain tumor resections near eloquent areas.
• It also serves stereotactic brain biopsy, ventriculostomy, and supratentorial tumor resections.
• Benefits include avoiding general anesthesia risks, shorter hospital stays, and reduced resource utilization.

Purpose of the Study:

• To review and present anesthetic techniques for awake craniotomy.
• To highlight the importance of patient comfort, pain management, and cooperation during the procedure.

Main Methods:

• Review of literature on anesthetic approaches for awake craniotomy.
• Discussion of scalp blockage, sedation protocols, and airway management strategies.
• Emphasis on the use of long-acting local anesthetics (e.g., bupivacaine) and sedatives (e.g., propofol, dexmedetomidine, remifentanyl).

Main Results:

• Anesthetic management requires careful planning and experienced personnel.
• Effective pain control and sedation are crucial for patient cooperation.
• Specific anesthetic agents and techniques are vital for successful outcomes.

Conclusions:

• Successful awake craniotomy relies on detailed planning and execution of anesthetic procedures.
• Anesthesiologists play a key role in ensuring patient safety and comfort.
• This technique offers a viable alternative for specific neurosurgical interventions.