Anesthesia for awake craniotomy: An update
Keywords:
Craniotomy, Epilepsy, Brain neoplasms, Anesthesia, Perioperative period
Abstract
Awake craniotomy has become a common procedure and its application has been continually evolving. Anesthesia for awake craniotomy poses a unique challenge to anesthesiologists. The aims of this article are to review under a critical perspective of the author, the current evidence and application of awake craniotomy and to briefly describe the principles of anesthetic management during this procedure.
References
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2. Szelényi A, Bello L, Duffau H, Fava E, Feigl GC, Galanda M, et al. Intraoperative electrical stimulation in awake craniotomy: methodological aspects of current practice. Neurosurg Focus. 2010;28:E7.
3. Nguyen HS, Sundaram SV, Mosier KM, Cohen-Gadol AA. A method to map the visual cortex during an awake craniotomy. J Neurosurg. 2011;114:922-6.
4. Chui J, Manninen P, Valiante T, Venkatraghavan L. The anesthetic considerations of intraoperative electrocorticography during epilepsy surgery. Anesth Analg. 2013;117:479-86.
5. Larkin M. Neurosurgeons wake up to awake-brain surgery. Lancet. 1999;353:1772.
6. Taylor MD, Bernstein M. Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg. 1999;90:35-41.
7. Serletis D, Bernstein M. Prospective study of awake craniotomy used routinely and nonselectively for supratentorial tumors. J Neurosurg. 2007;107:1-6.
8. Brown T, Shah AH, Bregy A, Shah NH, Thambuswamy M, Barbarite E, et al. Awake craniotomy for brain tumor resection: the rule rather than the exception? J Neurosurg Anesthesiol. 2013;25:240-7.
9. Sacko O, Lauwers-Cances V, Brauge D, Sesay M, Brenner A, Roux FE. Awake craniotomy vs surgery under general anesthesia for resection of supratentorial lesions. Neurosurgery. 2011;68:1192-8, discussion 1198-9.
10. Gupta DK, Chandra PS, Ojha BK, Sharma BS, Mahapatra AK, Mehta VS. Awake craniotomy versus surgery under general anesthesia for resection of intrinsic lesions of eloquent cortex - a prospective randomised study. Clin Neurol Neurosurg. 2007;109:335-43.
11. Erickson KM, Cole DJ. Anesthetic considerations for awake craniotomy for epilepsy and functional neurosurgery. Anesthesiol Clin. 2012;30:241-68.
12. Nossek E, Matot I, Shahar T, Barzilai O, Rapoport Y, Gonen T, et al. Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor. J Neurosurg. 2013;118:243-9.
13. Santini B, Talacchi A, Casagrande F, Casartelli M, Savazzi S, Procaccio F, et al. Eligibility criteria and psychological profiles in patient candidates for awake craniotomy: a pilot study. J Neurosurg Anesthesiol. 2012;24:209-16.
14. Klimek M, Verbrugge SJ, Roubos S, van der Most E, Vincent AJ, Klein J. Awake craniotomy for glioblastoma in a 9-year-old child. Anaesthesia. 2004;59:607-9.
15. Sarang A, Dinsmore J. Anaesthesia for awake craniotomy - evolution of a technique that facilitates awake neurological testing. Br J Anaesth. 2003;90:161-5.
16. Olsen KS. The asleep-awake technique using propofol-remifentanil anaesthesia for awake craniotomy for cerebral tumours. Eur J Anaesthesiol. 2008;25:662-9.
17. Skucas AP, Artru AA. Anesthetic complications of awake craniotomies for epilepsy surgery. Anesth Analg. 2006;102:882-7.
18. Gignac E, Manninen PH, Gelb AW. Comparison of fentanyl, sufentanil and alfentanil during awake craniotomy for epilepsy. Can J Anaesth. 1993;40 5 Pt 1:421-4.
19. Manninen PH, Balki M, Lukitto K, Bernstein M. Patient satisfaction with awake craniotomy for tumor surgery: a comparison of remifentanil and fentanyl in conjunction with propofol. Anesth Analg. 2006;102:237-42.
20. Keifer JC, Dentchev D, Little K, Warner DS, Friedman AH, Borel CO. A retrospective analysis of a remifentanil/propofol general anesthetic for craniotomy before awake functional brain mapping. Anesth Analg. 2005;101:502-8.
21. Bekker AY, Kaufman B, Samir H, Doyle W. The use of dexmedetomidine infusion for awake craniotomy. Anesth Analg. 2001;92:1251-3.
22. Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes MD, Lee L, et al. Dexmedetomidine sedation during awake craniotomy for seizure resection: effects on electrocorticography. J Neurosurg Anesthesiol. 2007;19:38-44.
23. Bustillo MA, Lazar RM, Finck AD, Fitzsimmons B, Berman MF, Pile-Spellman J, et al. Dexmedetomidine may impair cognitive testing during endovascular embolization of cerebral arteriovenous malformations: a retrospective case report series. J Neurosurg Anesthesiol. 2002;14: 209-12.
24. Bernstein M. Outpatient craniotomy for brain tumor: a pilot feasibility study in 46 patients. Can J Neurol Sci. 2001;28:120-4.
25. Blanshard HJ, Chung F, Manninen PH, Taylor MD, Bernstein M. Awake craniotomy for removal of intracranial tumor: considerations for early discharge. Anesth Analg. 2001;92:89-94.
26. Boulton M, Bernstein M. Outpatient brain tumor surgery: innovation in surgical neurooncology. J Neurosurg. 2008;108:649-54.
27. Carrabba G, Venkatraghavan L, Bernstein M. Day surgery awake craniotomy for removing brain tumours: technical note describing a simple protocol. Minim Invasive Neurosurg. 2008;51:208-10.
28. Lobo F, Beiras A. Propofol and remifentanil effect-site concentrations estimated by pharmacokinetic simulation and bispectral index monitoring during craniotomy with intraoperative awakening for brain tumor resection. J Neurosurg Anesthesiol. 2007;19:183-9.
29. Balki M, Manninen PH, McGuire GP, El-Beheiry H, Bernstein M. Venous air embolism during awake craniotomy in a supine patient. Can J Anaesth. 2003;50:835-8.
30. Bonhomme V, Franssen C, Hans P. Awake craniotomy. Eur J Anaesthesiol. 2009;26:906-12.
31. Costello TG. Awake craniotomy and multilingualism: language testing during anaesthesia for awake craniotomy in a bilingual patient. J Clin Neurosci. 2014;12:123-4.
32. Milian M, Tatagiba M, Feigl GC. Patient response to awake craniotomy - a summary overview. Acta Neurochir (Wien). 2014;156:1063-70.
33. Shinoura N, Midorikawa A, Yamada R, Hana T, Saito A, Hiromitsu K, et al. Awake craniotomy for brain lesions within and near the primary motor area: a retrospective analysis of factors associated with worsened paresis in 102 consecutive patients. Surg Neurol Int. 2013;4:149.
34. Bilotta F, Stazi E, Titi L, Lalli D, Delfini R, Santoro A, et al. Diagnostic work up for language testing in patients undergoing awake craniotomy for brain lesions in language areas. Br J Neurosurg. 2013.
35. Garavaglia MM, Das S, Cusimano MD, Crescini C, Mazer CD, Hare GM, et al. Anesthetic approach to high-risk patients and prolonged awake craniotomy using dexmedetomidine and scalp block. J Neurosurg Anesthesiol. 2013.
36. Bilotta F, Titi L, Lanni F, Stazi E, Rosa G. Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load. J Clin Anesth. 2013;25:359-66.
37. Hansen E, Seemann M, Zech N, Doenitz C, Luerding R, Brawanski A. Awake craniotomies without any sedation: the awake-awake-awake technique. Acta Neurochir (Wien). 2013;155:1417-24.
38. Ouyang MW, McDonagh DL, Phillips-Bute B, James ML, Friedman AH, Gan TJ. Comparison of postoperative nausea between benign and malignant brain tumor patients undergoing awake craniotomy: a retrospective analysis. Curr Med Res Opin. 2013;29:1039-44.
39. Ouyang MW, McDonagh DL, Phillips-Bute B, James ML, Friedman AH, Gan TJ. Does midline shift predict postoperative nausea in brain tumor patients undergoing awake craniotomy? A retrospective analysis. Curr Med Res Opin. 2013;29:1033-8.
40. Nossek E, Matot I, Shahar T, Barzilai O, Rapoport Y, Gonen T, et al. Intraoperative seizures during awake craniotomy: incidence and consequences: analysis of 477 patients. Neurosurgery. 2013;73:135-40, discussion 140.
2. Szelényi A, Bello L, Duffau H, Fava E, Feigl GC, Galanda M, et al. Intraoperative electrical stimulation in awake craniotomy: methodological aspects of current practice. Neurosurg Focus. 2010;28:E7.
3. Nguyen HS, Sundaram SV, Mosier KM, Cohen-Gadol AA. A method to map the visual cortex during an awake craniotomy. J Neurosurg. 2011;114:922-6.
4. Chui J, Manninen P, Valiante T, Venkatraghavan L. The anesthetic considerations of intraoperative electrocorticography during epilepsy surgery. Anesth Analg. 2013;117:479-86.
5. Larkin M. Neurosurgeons wake up to awake-brain surgery. Lancet. 1999;353:1772.
6. Taylor MD, Bernstein M. Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg. 1999;90:35-41.
7. Serletis D, Bernstein M. Prospective study of awake craniotomy used routinely and nonselectively for supratentorial tumors. J Neurosurg. 2007;107:1-6.
8. Brown T, Shah AH, Bregy A, Shah NH, Thambuswamy M, Barbarite E, et al. Awake craniotomy for brain tumor resection: the rule rather than the exception? J Neurosurg Anesthesiol. 2013;25:240-7.
9. Sacko O, Lauwers-Cances V, Brauge D, Sesay M, Brenner A, Roux FE. Awake craniotomy vs surgery under general anesthesia for resection of supratentorial lesions. Neurosurgery. 2011;68:1192-8, discussion 1198-9.
10. Gupta DK, Chandra PS, Ojha BK, Sharma BS, Mahapatra AK, Mehta VS. Awake craniotomy versus surgery under general anesthesia for resection of intrinsic lesions of eloquent cortex - a prospective randomised study. Clin Neurol Neurosurg. 2007;109:335-43.
11. Erickson KM, Cole DJ. Anesthetic considerations for awake craniotomy for epilepsy and functional neurosurgery. Anesthesiol Clin. 2012;30:241-68.
12. Nossek E, Matot I, Shahar T, Barzilai O, Rapoport Y, Gonen T, et al. Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor. J Neurosurg. 2013;118:243-9.
13. Santini B, Talacchi A, Casagrande F, Casartelli M, Savazzi S, Procaccio F, et al. Eligibility criteria and psychological profiles in patient candidates for awake craniotomy: a pilot study. J Neurosurg Anesthesiol. 2012;24:209-16.
14. Klimek M, Verbrugge SJ, Roubos S, van der Most E, Vincent AJ, Klein J. Awake craniotomy for glioblastoma in a 9-year-old child. Anaesthesia. 2004;59:607-9.
15. Sarang A, Dinsmore J. Anaesthesia for awake craniotomy - evolution of a technique that facilitates awake neurological testing. Br J Anaesth. 2003;90:161-5.
16. Olsen KS. The asleep-awake technique using propofol-remifentanil anaesthesia for awake craniotomy for cerebral tumours. Eur J Anaesthesiol. 2008;25:662-9.
17. Skucas AP, Artru AA. Anesthetic complications of awake craniotomies for epilepsy surgery. Anesth Analg. 2006;102:882-7.
18. Gignac E, Manninen PH, Gelb AW. Comparison of fentanyl, sufentanil and alfentanil during awake craniotomy for epilepsy. Can J Anaesth. 1993;40 5 Pt 1:421-4.
19. Manninen PH, Balki M, Lukitto K, Bernstein M. Patient satisfaction with awake craniotomy for tumor surgery: a comparison of remifentanil and fentanyl in conjunction with propofol. Anesth Analg. 2006;102:237-42.
20. Keifer JC, Dentchev D, Little K, Warner DS, Friedman AH, Borel CO. A retrospective analysis of a remifentanil/propofol general anesthetic for craniotomy before awake functional brain mapping. Anesth Analg. 2005;101:502-8.
21. Bekker AY, Kaufman B, Samir H, Doyle W. The use of dexmedetomidine infusion for awake craniotomy. Anesth Analg. 2001;92:1251-3.
22. Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes MD, Lee L, et al. Dexmedetomidine sedation during awake craniotomy for seizure resection: effects on electrocorticography. J Neurosurg Anesthesiol. 2007;19:38-44.
23. Bustillo MA, Lazar RM, Finck AD, Fitzsimmons B, Berman MF, Pile-Spellman J, et al. Dexmedetomidine may impair cognitive testing during endovascular embolization of cerebral arteriovenous malformations: a retrospective case report series. J Neurosurg Anesthesiol. 2002;14: 209-12.
24. Bernstein M. Outpatient craniotomy for brain tumor: a pilot feasibility study in 46 patients. Can J Neurol Sci. 2001;28:120-4.
25. Blanshard HJ, Chung F, Manninen PH, Taylor MD, Bernstein M. Awake craniotomy for removal of intracranial tumor: considerations for early discharge. Anesth Analg. 2001;92:89-94.
26. Boulton M, Bernstein M. Outpatient brain tumor surgery: innovation in surgical neurooncology. J Neurosurg. 2008;108:649-54.
27. Carrabba G, Venkatraghavan L, Bernstein M. Day surgery awake craniotomy for removing brain tumours: technical note describing a simple protocol. Minim Invasive Neurosurg. 2008;51:208-10.
28. Lobo F, Beiras A. Propofol and remifentanil effect-site concentrations estimated by pharmacokinetic simulation and bispectral index monitoring during craniotomy with intraoperative awakening for brain tumor resection. J Neurosurg Anesthesiol. 2007;19:183-9.
29. Balki M, Manninen PH, McGuire GP, El-Beheiry H, Bernstein M. Venous air embolism during awake craniotomy in a supine patient. Can J Anaesth. 2003;50:835-8.
30. Bonhomme V, Franssen C, Hans P. Awake craniotomy. Eur J Anaesthesiol. 2009;26:906-12.
31. Costello TG. Awake craniotomy and multilingualism: language testing during anaesthesia for awake craniotomy in a bilingual patient. J Clin Neurosci. 2014;12:123-4.
32. Milian M, Tatagiba M, Feigl GC. Patient response to awake craniotomy - a summary overview. Acta Neurochir (Wien). 2014;156:1063-70.
33. Shinoura N, Midorikawa A, Yamada R, Hana T, Saito A, Hiromitsu K, et al. Awake craniotomy for brain lesions within and near the primary motor area: a retrospective analysis of factors associated with worsened paresis in 102 consecutive patients. Surg Neurol Int. 2013;4:149.
34. Bilotta F, Stazi E, Titi L, Lalli D, Delfini R, Santoro A, et al. Diagnostic work up for language testing in patients undergoing awake craniotomy for brain lesions in language areas. Br J Neurosurg. 2013.
35. Garavaglia MM, Das S, Cusimano MD, Crescini C, Mazer CD, Hare GM, et al. Anesthetic approach to high-risk patients and prolonged awake craniotomy using dexmedetomidine and scalp block. J Neurosurg Anesthesiol. 2013.
36. Bilotta F, Titi L, Lanni F, Stazi E, Rosa G. Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load. J Clin Anesth. 2013;25:359-66.
37. Hansen E, Seemann M, Zech N, Doenitz C, Luerding R, Brawanski A. Awake craniotomies without any sedation: the awake-awake-awake technique. Acta Neurochir (Wien). 2013;155:1417-24.
38. Ouyang MW, McDonagh DL, Phillips-Bute B, James ML, Friedman AH, Gan TJ. Comparison of postoperative nausea between benign and malignant brain tumor patients undergoing awake craniotomy: a retrospective analysis. Curr Med Res Opin. 2013;29:1039-44.
39. Ouyang MW, McDonagh DL, Phillips-Bute B, James ML, Friedman AH, Gan TJ. Does midline shift predict postoperative nausea in brain tumor patients undergoing awake craniotomy? A retrospective analysis. Curr Med Res Opin. 2013;29:1033-8.
40. Nossek E, Matot I, Shahar T, Barzilai O, Rapoport Y, Gonen T, et al. Intraoperative seizures during awake craniotomy: incidence and consequences: analysis of 477 patients. Neurosurgery. 2013;73:135-40, discussion 140.
How to Cite
1.
Chui J. Anesthesia for awake craniotomy: An update. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Apr. 23];43(Supplement):22-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/716
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2015-07-01
How to Cite
1.
Chui J. Anesthesia for awake craniotomy: An update. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Apr. 23];43(Supplement):22-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/716
Section
Narrative review
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