Nonopioid anesthesia for awake craniotomy: a case report.
AANA J
; 78(1): 29-32, 2010 Feb.
Article
en En
| MEDLINE
| ID: mdl-20977126
ABSTRACT
Awake craniotomy is becoming more popular as a neurosurgical technique that allows for increased tumor resection and decreased postoperative neurologic morbidity. This technique, however, presents many challenges to both the neurosurgeon and anesthetist. An ASA class II, 37-year-old man with recurrent oligodendroglioma presented for repeated craniotomy. Prior craniotomy under general anesthesia resulted in residual neurologic deficits. An awake craniotomy was planned to allow for intraoperative testing for maximum tumor resection and avoidance of neurologic morbidity. The patient was sedated with propofol, and bupivacaine was infiltrated for placement of Mayfield tongs and skin incision. Following exposure of brain tissue, propofol infusion was discontinued to allow for patient cooperation during the procedure. Speech, motor, and sensory testing occurred during tumor resection until resection stopped after onset of weakness in the right arm. The propofol infusion was resumed while the cranium was closed and Mayfield tongs removed. The patient was awake, alert, oriented, and able to move all extremities but had residual weakness in the right forearm. Awake craniotomy requires appropriate patient selection, knowledge of the surgeon's skill, and a thorough anesthesia plan. This case report discusses the clinical and anesthetic management for awake craniotomy and reviews the literature.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Concienciación
/
Anestésicos Intravenosos
/
Craneotomía
/
Anestesia
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
AANA J
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos