8 research outputs found
Anesthesia for awake craniotomy: A retrospective study
Context: Awake craniotomy is increasingly performed the world over. We
share our experience of performing craniotomy awake with our anesthetic
protocol. Aims: To evaluate and analyze the anesthesia records of the
patients who underwent awake craniotomy at our institution. Settings
and Design: University teaching hospital, Retrospective study.
Materials and Methods: We reviewed records of the 42 consecutive
patients who underwent awake craniotomy under conscious sedation using
Fentanyl and Propofol infusion until December 2005. The drugs were
titrated (Bispectral monitoring was used in 16 patients) to facilitate
intermittent intraoperative neurological testing. All patients received
scalp blocks with a mixture of bupivacaine and lignocaine with
adrenaline. Haloperidol and ondansetron were administered in all
patients at induction of anesthesia. Results: All patients completed
the procedure. One patient each needed endotracheal intubation and LMA
for airway control during closure, while another required CPAP
perioperatively because of desaturation to < 80%. There was
significantly decreased use of anesthetics ( P < 0.001) and a trend
towards reduction in complications (e.g. respiratory depression and
deep sedation) ( P >0.05) with the use of BIS as compared to without
BIS. Intraoperative complications were hypertension (19%), tight brain
(14.2%), focal seizure (9.5%) respiratory depression (7.1%), deep
sedation (7.1%), tachycardia (7.1%) and bradycardia. Two patients
desaturated to < 95%. 23.8% patients developed transient
neurological deficits. The most frequent postoperative complications
were PONV (19%) and seizures (16.6%). Conclusions: With the use of
advanced monitoring and newer anesthetics, awake craniotomy is a
relatively safe procedure with an accepted rate of complications