Anaesthesia for awake craniotomy is safe and well-tolerated

TY - JOUR

T1 - Anaesthesia for awake craniotomy is safe and well-tolerated

AU - Andersen, Jakob Hessel

AU - Olsen, Karsten Skovgaard

PY - 2010/10/1

Y1 - 2010/10/1

N2 - Introduction: Awake craniotomy for tumour resection has been performed at Glostrup Hospital since 2004. We describe and discuss the various anaesthetic approaches for such surgery and retrospectively analyse the 44 planned awake craniotomies performed at Glostrup Hospital. The surgery falls into four phases: craniotomy, mapping, tumour resection and closing. Three methods are being used: monitored anaesthetic care, asleep-awake-asleep and asleepawake (AA). Material and Methods: Anaesthesia is induced and maintained with propofol and remifentanil. A laryngeal mask (LM) is used as an airway during the craniotomy phase. In the AA method, patients are mapped and the tumour is resected while the patient is awake. Results: A total of 41 of 44 planned AA craniotomies were performed. Three had to be onverted into general anaesthesia (GA) due to tight brain, leaking LM and tumour haemorrhage, respectively. The following complications were observed: bradycardia 10%, leaking LM 5%, nausea 10%, vomiting 5%, focal seizures 28%, generalized seizures 10%, hypoxia 2%, hypotension 5% and hypertension 2%.Discussion: Our results comply well with the international literature in terms of complications related to haemodynamics, respiration, seizures, vomiting and nausea and in terms of patient satisfaction. Awake craniotomy is a welltolerated procedure with potential benefits. More prospective randomized studies are required.

AB - Introduction: Awake craniotomy for tumour resection has been performed at Glostrup Hospital since 2004. We describe and discuss the various anaesthetic approaches for such surgery and retrospectively analyse the 44 planned awake craniotomies performed at Glostrup Hospital. The surgery falls into four phases: craniotomy, mapping, tumour resection and closing. Three methods are being used: monitored anaesthetic care, asleep-awake-asleep and asleepawake (AA). Material and Methods: Anaesthesia is induced and maintained with propofol and remifentanil. A laryngeal mask (LM) is used as an airway during the craniotomy phase. In the AA method, patients are mapped and the tumour is resected while the patient is awake. Results: A total of 41 of 44 planned AA craniotomies were performed. Three had to be onverted into general anaesthesia (GA) due to tight brain, leaking LM and tumour haemorrhage, respectively. The following complications were observed: bradycardia 10%, leaking LM 5%, nausea 10%, vomiting 5%, focal seizures 28%, generalized seizures 10%, hypoxia 2%, hypotension 5% and hypertension 2%.Discussion: Our results comply well with the international literature in terms of complications related to haemodynamics, respiration, seizures, vomiting and nausea and in terms of patient satisfaction. Awake craniotomy is a welltolerated procedure with potential benefits. More prospective randomized studies are required.

M3 - Journal article

SN - 1603-9629

VL - 57

SP - A4194

JO - Danish Medical Bulletin (Online)

JF - Danish Medical Bulletin (Online)

IS - 10

ER -