Anesthesia for Awake Craniotomy: What Is New?

AbstractPurpose of ReviewThe purpose of this article is to review the current evidence on perioperative management for awake craniotomy (AC).Recent FindingsWith the advancement of diagnostic modalities, newer intraoperative monitoring technologies, and safer and shorter-acting anesthetic agents, the indications of AC are expanding beyond epilepsy surgery. Anesthesia techniques including asleep-awake-asleep and monitored anesthesia care are generally safe and without any serious side effects when performed by experienced providers; however, data regarding awake-awake-awake technique is limited. Currently, an α-2 agonist, dexmedetomidine, is gaining popularity both as a sole agent as well as an adjunct for AC as it provides analgesia with minimal respiratory depression and it minimally interferes with electrocorticography and cortical mapping. The use of dexmedetomidine allows reduction of opioid and pr opofol doses while preserving hemodynamic stability.SummaryThe success of AC is based on the appropriate patient selection, detailed preoperative evaluation, adequate preparation, and prevention, timely detection, and efficient management of the intraoperative complications.

Source: Current Anesthesiology Reports - July 18, 2018 Category: Anesthesiology Source Type: research