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2025, Number 1

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Acta Med 2025; 23 (1)

Craniotomy with tumor resection in an awake patient: anesthetic challenge or unnecessary risk?

Serrano MMD, Salinas MAJ, Millán MR, Alvarado BNA
Full text How to cite this article 10.35366/119357

DOI

DOI: 10.35366/119357
URL: https://dx.doi.org/10.35366/119357

Language: Spanish
References: 5
Page: 59-60
PDF size: 173.91 Kb.


Key words:

awake craniotomy, anesthetic neuromonitoring, total intravenous anesthesia, regional anesthesia.

ABSTRACT

Introduction: awake craniotomy for resection of lesions involving motor or eloquent areas demands precise anesthetic techniques to control consciousness levels during surgery and conduct intraoperative neuropsychological testing. This presents pharmacological, airway permeability, anesthetic depth, and monitoring challenges for anesthesiologists. Case report: a 64-year-old female with a right frontoparietal tumor underwent a craniotomy. The anesthetic technique involved initial total intravenous anesthesia, scalp block, and subsequent transition to conscious sedation for tumor resection, allowing real-time neuropsychological assessment. Postoperative evolution was favorable, demonstrating the feasibility and safety of the asleep-awake technique.


REFERENCES

  1. Kim SH, Choi SH. Anesthetic considerations for awake craniotomy. Anesth Pain Med (Seoul). 2020; 15 (3): 269-274.

  2. Ramírez-Segura EH, Bataz-Pita BY. Abordaje Perioperatorio en Cirugía neurológica con El Paciente Despierto. Rev Mex Anestesiol. 2022; 45 (2): 114-120.

  3. Natalini D, Ganau M, Rosenkranz R, Petrinic T, Fitzgibbon K, Antonelli M et al. Comparison of the asleep-awake-asleep technique and monitored anesthesia care during awake craniotomy: a systematic review and meta-analysis. J Neurosurg Anesthesiol. 2020; 34 (1): e1-e13.

  4. Madriz-Godoy MM, Trejo-Gallegos SA. Anaesthetic technique during awake craniotomy. Case report and literature review. Rev Medica Hosp Gen Mex. 2016; 79 (3): 155-160.

  5. Sewell D, Smith M. Awake craniotomy: anesthetic considerations based on outcome evidence. Curr Opin Anaesthesiol. 2019; 32 (5): 546-552.




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C?MO CITAR (Vancouver)

Acta Med. 2025;23