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lunes, 5 de agosto de 2013

Awake craniotomy, an unusual indication

Resection of brain tumours carries a great potential of functional impairment, especially if the tumour is nestled close to functional areas of the brain. To escape this risk, awake craniotomy has been proposed as a surgical technique to facilitate maximum tumour resection with minimum impairment of neurological function. To have an awake cooperative patient who is compliant with neurological assessment, the technique should provide adequate sedation, analgesia, respiratory and haemodynamic stability. In this study, we reviewed the effectiveness of awake craniotomy as an alternative anaesthetic technique to general anaesthesia in twenty patients. All selected patients were suffering from variable co-morbidities that represent a constant threat to life if tumour resection is performed under general anaesthesia. Craniotomy was done under local anaesthesia and monitored conscious sedation. The candidates well tolerated the procedure (both sedation and pain scores ranged from 1 to 3), with haemodynamic stability (intra-operative heart rate was 84.4500±7.59830 and MAP was 90.6500 ±10.28169) and adequate respiratory functions throughout the procedure (mean respiratory rate was 12.8± 1.63 breaths per minute and mean oxygen saturation was 97.35% ± 1.5). Convenient resection of the tumor was achieved and uneventful post-operative recovery with minimal neurological deficits was reported in all cases.The technique used, adequately met the requirement for awake craniotomy in such group of patients having a relative risk from general anaesthesia.http://www.scribd.com/doc/158247845/Awake-craniotomy-an-unusual-indication http://www.scribd.com/iMedPub



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