K Prabhakaran1, Cvr Mohan2, P C Tripathy3, P K Sahoo4, K I Mathai5. 1. Classified Specialist (Anaesthesia and Neuroanaesthesia), 166 Military Hospital, C/o 56 APO. 2. Professor and Head (Department of Anaesthesiology), AFMC, Pune. 3. Senior Advisor (Anaesthesiology), 158 Base Hospital C/o 99 APO. 4. Commandant, MH Namkum. 5. Senior Advisor (Neurosurgery), Command Hospital (SC), Pune.
Abstract
BACKGROUND: Craniotomy and excision of tumours can produce neurological deficits if the tumour is located close to eloquent areas of the brain. One technique of overcoming this problem is to keep the patient 'awake' during surgery. METHODS: Eight patients with intra cranial space occupying lesions (ICSOL) were operated 'awake', using a combination of skull block with sedation and analgesia. A mixture of 0.125% bupivacaine and 0.5% lignocaine was used for various nerve and field blocks. Midazolam, fentanyl and propofol in titrated doses were used to achieve conscious sedation. RESULT: The procedure was successful in all the patients. They tolerated the procedure well and were able to follow the commands intraoperatively as desired. There were no significant complications. CONCLUSION: Awake craniotomy with skull blocks with sedation and analgesia is a well established procedure. It requires a good rapport between surgeon, anaesthesiologist and the patient.
BACKGROUND: Craniotomy and excision of tumours can produce neurological deficits if the tumour is located close to eloquent areas of the brain. One technique of overcoming this problem is to keep the patient 'awake' during surgery. METHODS: Eight patients with intra cranial space occupying lesions (ICSOL) were operated 'awake', using a combination of skull block with sedation and analgesia. A mixture of 0.125% bupivacaine and 0.5% lignocaine was used for various nerve and field blocks. Midazolam, fentanyl and propofol in titrated doses were used to achieve conscious sedation. RESULT: The procedure was successful in all the patients. They tolerated the procedure well and were able to follow the commands intraoperatively as desired. There were no significant complications. CONCLUSION: Awake craniotomy with skull blocks with sedation and analgesia is a well established procedure. It requires a good rapport between surgeon, anaesthesiologist and the patient.
Authors: I A Herrick; R A Craen; A W Gelb; L A Miller; C S Kubu; J P Girvin; A G Parrent; M Eliasziw; J Kirkby Journal: Anesth Analg Date: 1997-06 Impact factor: 5.108