[Remifentanil for awake craniotomy].

ABSTRACT

We report two cases of awake craniotomy successfully managed using remifentanil. During the intraoperative awake period lasting 2 to 2.5 hours, the infusion of low doses of remifentanil (0.02-0.05 microg x kg(-1) min(-1)) with or without propofol kept the patients comfortable and sufficiently awake to conduct various tasks but did not produce excessive respiratory depression. Because remifentanil can be titrated rapidly due to its extremely short duration of action, it may be useful for awake craniotomy for which both analgesia and sedation have to be tuned carefully according to the patient's need.