Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 3:11:593-598.
doi: 10.2147/DDDT.S124736. eCollection 2017.

Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil

Andrea Prontera  1 , Stefano Baroni  2 , Andrea Marudi  2 , Franco Valzania  3 , Alberto Feletti  1 , Francesca Benuzzi  4 , Elisabetta Bertellini  2 , Giacomo Pavesi  1
Affiliations

Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil

Andrea Prontera et al. Drug Des Devel Ther. .

Abstract

Introduction: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing.

Methods: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management.

Results: The anesthetic protocol applied in our study has the advantage of decreasing the dose of each drug and thus reducing the occurrence of side effects. All patients had smooth and rapid awakenings. The brain remained relaxed during the entire procedure.

Conclusion: In our experience, this protocol is safe and effective during awake brain surgery. Nevertheless, prospective randomized trials are necessary to confirm the optimal anesthetic technique to be used.

Keywords: anesthesia; awake surgery; dexmedetomidine.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Piccioni F, Fanzio M. Management of anesthesia in awake craniotomy. Minerva Anestesiol. 2008;74(7–8):393–408. - PubMed
    1. Bharati S, Pal A, Biswas C, Biswas R. Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports. Acta Anaesthesiol Taiwan. 2011;49(4):165–167. - PubMed
    1. Ha SH, Park I-H, Lee M-H, Shi S-K, Min KT. Use of dexmedetomidine for awake craniotomy. Korean J Anesthesiol. 2011;61(4):346–347. - PMC - PubMed
    1. Erickson KM, Cole DJ. Anesthetic considerations for awake craniotomy for epilepsy and functional neurosurgery. Anesthesiol Clin. 2012;30(2):241–268. - PubMed
    1. Rozet I, Muangman S, Vavilala MS, et al. Clinical experience with dexmedetomidine for implantation of deep brain stimulators in Parkinson’s disease. Anesth Analg. 2006;103(5):1224–1228. - PubMed

MeSH terms