Research article summary (published 19 Feb 2008):

The asleep-awake technique using propofol-remifentanil anaesthesia for awake craniotomy for cerebral tumours.

Full Abstract

BACKGROUND AND OBJECTIVE: We retrospectively reviewed the first 25 planned cases of awake craniotomies using the 'asleep-awake' technique, an alternative to the often-used 'asleep-awake-asleep' technique. METHODS: The patients were anaesthetized using propofol/remifentanil anaesthesia, a laryngeal mask and controlled ventilation according to a protocol defined before the start of this series of patients. The patients were awakened before the brain mapping and were kept awake throughout the rest of the procedure allowing for additional mapping and modification of the resection of the tumour if symptoms should develop. A small dose of remifentanil was infused during this period if necessary. RESULTS: Twenty-three patients were mapped as planned. One patient was not awakened due to protrusion of the brain during the awakening phase. Another patient was intubated preoperatively as it was impossible to obtain a tight laryngeal mask. All of the 23 patients were awake as from when the mapping session began and throughout the rest of the operation. In five cases the resection of the tumour was modified as symptoms emerged. These symptoms all subsided in due course. No case of hypoxia was recorded. In no case the respiratory rate was below 10 breaths min-1 in the awake period. Complications were comparable to other studies. The patients in the present study were all satisfied with the method. CONCLUSIONS: Different methods of anaesthesia have been described, but no method has been shown to be superior. The presented method seems to be a rational and useful technique allowing for modification of tumour resection, if symptoms should develop. The method was well tolerated by the patients.

Author information

Author/s: Olsen, K S (KS);

Affiliation: Glostrup University Hospital, Department of Anaesthesia and Intensive Care, Glostrup, Denmark. karsko01(-atsign-)glostruphosp.kbhamt.dk

Journal and publication information

Publication Type: Journal Article; Validation Studies

Journal: European journal of anaesthesiology (Eur J Anaesthesiol), published in England. (Language: eng)

Reference: 2008-Aug; vol 25 (issue 8) : pp 662-9

Dates: Created 2008/07/01; Completed 2008/08/14; Revised 2009/06/15;

PMID: 18289443, status: MEDLINE (last retrieval date: 6/15/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Eur J Anaesthesiol. 2009 May;26(5):443-4. (PMID: 19521303)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Aged Anesthesia, General - methods Anesthetics, Intravenous Brain Mapping - methods Brain Neoplasms - surgery Craniotomy - methods Humans

Middle Aged Monitoring, Intraoperative - methods Patient Satisfaction Piperidines Propofol Retrospective Studies Treatment Outcome Wakefulness

Associated Chemicals: Anesthetics, Intravenous (0) ; Piperidines (0) ; remifentanil (132875-61-7) ; Propofol (2078-54-8)

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