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Awake craniotomy: anesthetic considerations based on outcome evidence
Darreul Sewell1, Martin Smith1,2
1Department of Neuroanaesthesia and Neurocritical Care Unit, The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Square.
Current Opinion in Anaesthesiology
|May 21, 2019
Summary
Awake craniotomy allows maximal tumor resection near eloquent brain regions. Various anesthesia techniques are effective, with success depending on patient factors and team expertise.
Area of Science:
- Neurosurgery
- Anesthesiology
Background:
- Awake craniotomy is crucial for resecting tumors near eloquent brain areas.
- It enables maximal tumor removal while preserving neurological function.
Purpose of the Study:
- To review anesthesia management options for awake craniotomy.
- To discuss advantages, disadvantages, complications, and future directions.
Main Methods:
- Review of current anesthesia and sedation techniques for awake craniotomy.
- Analysis of intraoperative complications and success rates.
Main Results:
- Multiple anesthesia approaches exist, with no single superior technique identified.
- Awake craniotomy is safe, with failure rates below 2% in experienced hands.
- Complications are generally minor and manageable.
Conclusions:
- Anesthesia choice depends on patient factors, surgery specifics, and anesthesiologist experience.
- Successful awake craniotomy relies on careful patient selection and multidisciplinary teamwork.
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