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
Review
. 2020 Jul 31;15(3):269-274.
doi: 10.17085/apm.20050.

Anesthetic considerations for awake craniotomy

Seung Hyun Kim  1 , Seung Ho Choi  1
Affiliations
Review

Anesthetic considerations for awake craniotomy

Seung Hyun Kim et al. Anesth Pain Med (Seoul). .

Abstract

Awake craniotomy is a gold standard of care for resection of brain tumors located within or close to the eloquent areas. Both asleep-awake-asleep technique and monitored anesthesia care have been used effectively for awake craniotomy and the choice of optimal anesthetic approach is primarily based on the preferences of the anesthesiologist and surgical team. Propofol, remifentanil, dexmedetomidine, and scalp nerve block provide the reliable conditions for intraoperative brain mapping. Appropriate patient selection, adequate perioperative psychological support, and proper anesthetic management for individual patients in each stage of surgery are crucial for procedural safety, success, and patient satisfaction.

Keywords: Awake craniotomy; Brain neoplasms; Conscious sedation; Craniotomy.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported.

References

    1. Uff C, Frith D, Harrison C, Powell M, Kitchen N. Sir Victor Horsley's 19th century operations at the National Hospital for Neurology and Neurosurgery, Queen Square. J Neurosurg. 2011;114:534–42. - PubMed
    1. Stevanovic A, Rossaint R, Veldeman M, Bilotta F, Coburn M. Anaesthesia management for awake craniotomy: systematic review and meta-analysis. PLoS One. 2016;11:e0156448. - PMC - PubMed
    1. Gerritsen JKW, Arends L, Klimek M, Dirven CMF, Vincent AJE. Impact of intraoperative stimulation mapping on high-grade glioma surgery outcome: a meta-analysis. Acta Neurochir (Wien) 2019;161:99–107. - PMC - PubMed
    1. Eseonu CI, Rincon-Torroella J, ReFaey K, Lee YM, Nangiana J, Vivas-Buitrago T, et al. Awake craniotomy vs craniotomy under general anesthesia for perirolandic gliomas: evaluating perioperative complications and extent of resection. Neurosurgery. 2017;81:481–9. - PubMed
    1. Meng L, Berger MS, Gelb AW. The potential benefits of awake craniotomy for brain tumor resection: an anesthesiologist's perspective. J Neurosurg Anesthesiol. 2015;27:310–7. - PubMed

LinkOut - more resources