Management of anesthesia in awake craniotomy

Minerva Anestesiologica

Volumn 74, Issue 7-8, 2008, Pages 393-408

  Piccioni, F ^a   Fanzio, M ^b  

^a NATIONAL CANCER INSTITUTE   (Italy)

^b FONDAZIONE IRCCS POLICLINICO SAN MATTEO   (Italy)

Author keywords

Anesthesia; Brain mapping; Brain neoplasms; Craniotomy; Dexmedetomidine; Propofol; Remifentanil

Indexed keywords

ALFENTANIL; ANTICONVULSIVE AGENT; ANTIEMETIC AGENT; BENZODIAZEPINE DERIVATIVE; CLONIDINE; DESFLURANE; DEXAMETHASONE; DEXDOMITOR; DEXMEDETOMIDINE; DIAZEPAM; DROPERIDOL; DROPERIDOL PLUS FENTANYL; FENTANYL; ISOFLURANE; LOCAL ANESTHETIC AGENT; METOCLOPRAMIDE; MIDAZOLAM; NEUROLEPTIC AGENT; NITRIC OXIDE; ONDANSETRON; OPIATE; PETHIDINE; PROPOFOL; RANITIDINE; REMIFENTANIL; SEVOFLURANE; SUFENTANIL; SUXAMETHONIUM; THIOPENTAL; UNINDEXED DRUG; URAPIDIL;

AGITATION; AIR EMBOLISM; AIRWAY OBSTRUCTION; ANESTHESIA; BRADYCARDIA; BRAIN ARTERIOVENOUS MALFORMATION; BRAIN DEPTH STIMULATION; BRAIN EDEMA; BRAIN MAPPING; BRAIN TUMOR; CLINICAL TRIAL; CONTINUOUS INFUSION; CRANIOTOMY; DISTRESS SYNDROME; DRUG BLOOD LEVEL; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG MECHANISM; DRUG MEGADOSE; DRUG RECEPTOR BINDING; DRUG SAFETY; ENDOTRACHEAL TUBE; EPILEPSY; GENERAL ANESTHESIA; GLIOMA; GRAND MAL SEIZURE; HUMAN; HYPERTENSION; HYPOTENSION; HYPOXIA; INTRACTABLE EPILEPSY; LARYNGEAL MASK; LOCAL ANESTHESIA; LOW DRUG DOSE; MOTOR CORTEX; MYCOTIC ANEURYSM; MYOCLONUS; NAUSEA; NAUSEA AND VOMITING; NERVE BLOCK; NEUROLEPTANALGESIA; PATIENT MONITORING; PATIENT SATISFACTION; PREMEDICATION; PREOPERATIVE EVALUATION; PROGNOSIS; REVIEW; SEDATION; SHIVERING; SIDE EFFECT; SOMATOSENSORY CORTEX; SURGICAL APPROACH; TACHYCARDIA; TONIC CLONIC SEIZURE;

ANESTHESIA; AWARENESS; BRAIN; CRANIOTOMY; FORECASTING; HUMANS;

EID: 48749125203     PISSN: 03759393     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (110)

1. Burchiel KJ, Clarke H, Ojemann GA, Dacey RG, Winn HR. Use of stimulation mapping and corticography in the excision of arteriovenous malformations in sensorimotor and language-related neocortex. Neurosurgery 1989;24:322-7.
2. Duffau H, Capelle L, Sichez JP, Faillot T, Abdennour L, Law Koune JD et al. Intra-operative direct stimulations of the central nervous system: the Salptrière experience with 60 patients. Acta Neurochir (Wien) 1999;141:1157-67.
3. Lüders JC, Steinmetz MP, Mayberg MR. Awake craniotomy for microsurgical obliteration of mycotic aneurysms: technical report of three cases. Neurosurgery 2005;56:ONS-E201.
4. Bernstein M. Outpatient craniotomy for brain tumor: a pilot feasibility study in 46 patients. Can J Neurol Sci 2001;28:120-4.
5. Blanshard HJ, Chung F, Manninen PH, Taylor MD, Bernstein M. Awake craniotomy for removal of intracranial tumor: considerations for early discharge. Anesth Analg 2001;92:89-94.
6. Saltarini M. Tecnica anestesiologica durante la awake craniotomy. In: Skrap M, editor. Mappaggio corticale e craniotomie a paziente sveglio. Trento: New Magazine Edizioni; 2004. p. 73-6.
7. Manninen PH, Tan TK. Postoperative nausea and vomiting after craniotomy for tumor surgery: a comparison between awake craniotomy and general anesthesia. J Clin Anesth 2002;14:279-83.
8. Manninen PH, Balki M, Lukitto K, Bernstein M. Patient satisfaction with awake craniotomy for tumor surgery: a comparison of remifentanil and fentanyl in conjunction with propofol. Anesth Analg 2006;102:237-42.
9. Bulsara KR, Johnson J, Villavicencio A. Improvements in brain tumor surgery: the modern history of awake craniotomies. Neurosurg Focus 2005;18-E5:1-3.
10. De Castro J, Mundeleer P. Anesthésie sans barbituriques. La neuroleptanalgésie. Anesth Anal 1959;16:1022.
11. Archer DP, McKenna JMA, Morin L, Ravussin P. Conscious sedation analgesia during craniotomy for intractable epilepsy: a review of 354 consecutive cases. Can J Anaesth 1988;35:338-44.
12. Welling E, Donegan J. Neuroleptanalgesia using alfentanil for awake craniotomy. Anesth Analg 1989;68:57-60.
13. Silbergeld DL, Mueller WM, Colley PS, Ojemann GA, Lettici E. Use of propofol (Diprivan) for awake craniotomies: technical note. Surg Neurol 1992;38:271-2.
14. Herrick IA, Craen RA, McLacklan RS, Girvin JP, Parrent AG, Eliasziw M et al. Propofol sedation during awake craniotomy for seizures: patient controlled administration versus neurolept analgesia. Anesth Analg 1997;84:1285-91.
15. Gignac E, Manninen PH, Gelb AW. Comparison of fentanyl, sufentanil and alfentanil during awake craniotomy for epilepsy. Can J Anaesth 1993;40:421-4.
16. Johnson KB, Egan TD. Remifentanil and propofol combination for awake craniotomy: case report with pharmacokinetic simulation. J Neurosurg Anesthesiol 1998;10:25-9.
17. Fukaya C, Katayama Y, Yoshino A, Kobayashi K, Kasai M, Yamamoto T. Intraoperative wake-up procedure with propofol and laryngeal mask for optimal excision of brain tumour in eloquent areas. J Clin Neurosci 2001;8:253-5.
18. Hans P, Bonhomme V, Born JD, Maertens de Noordhoudt A, Brichant JF, Dewandre PY. Target-controlled infusion of propofol and remifentanil combined with bispectral index monitoring for awake craniotomy. Anaesthesia 2000;55:255-9.
19. American Society of Anesthesiologists (ASA). Distinguishing monitored anesthesia care (MAC) from moderate sedation/analgesia (conscious sedation). Available from: www.asahq.org
20. Chernik DA, Gillings D, Laine H, Hendler J, Silver JM, Davidson AB et al. Validity and reliability of the Observer's Assessment of Alertness/Sedation Scale: study with intravenous midazolam. J Clin Psychopharmacol 1990;10:244-51.
21. Bonhomme V, Born JD, Hans P. Prise en charge anesthésique des craniotomies en état vigile. Ann Fr Anesth Réanim 2004; 23:389-94.
22. Costello TG, Cormack JR. Anaesthesia for awake craniotomy: a modern approach. J Clin Neurosci 2004;11:16-9.
23. Herrick IA, Craen RA, Gelb AW, McLachlan RS, Girvin JP, Parrent AG et al. Propofol during awake craniotomy for seizures: electrocorticographic and epileptogenic effects. Anesth Analg 1997;84:1280-4.
24. McGuire G, El-Beheiry H, Manninen F, Lozano A, Wennberg R. Activation of electrocorticographic activity with remifentanil and alfentanil during neurosurgical excision of epileptogenic focus. Br J Anaesth 2003;91:651-5.
25. Herrick IA, Craen RA, Blume WT, Novicl T, Gelb AW. Sedative doses of remifentanil have minimal effect on ECoG spike activity during awake epilepsy surgery. J Neurosurg Anesthesiol 2002;14:55-58.
26. Nikas DC, Danks RA, Black PM. Tumor surgery under local anesthesia. Techniques Neurosurg 2001;7:70-84.
27. Danks RA, Aglio LS, Gugino LD, Black PM. Craniotomy under local anesthesia and monitored conscious sedation for the resection of tumors involving eloquent cortex. J Neurooncol 2000;49:131-9.
28. Picht T, Kombos T, Gramm HJ, Brock M, Suess O. Multimodal protocol for awake craniotomy in language cortex tumour surgery Acta Neurochir (Wien) 2006;148: 127-38.
29. Tan TC, Black PM. Awake craniotomy for excision of brain metastases involving eloquent cortex. Techniques Neurosurg 2001;7:85-90.
30. Gruppo di studio per la sicurezza in anestesia e terapia intensive SIAARTI. Raccomandazioni per la valutazione anestesiologica per procedure diagnostiche-terapeutiche in elezione. Available from: www.siaarti.it
31. American Society of Anesthesiologists (ASA). Practice advisory of preanesthesia evaluation. Anesthesiology 2002;96:485-96.
32. Szelényi A, Joksimoviã B, Seifert V. intraoperative risk of seizures associated with transient direct cortical stimulation in patients with symptomatic epilepsy. J Clin Neurophysiol 2007;24:39-43.
33. Sarang A, Dinsmore J. Anaesthesia for awake craniotomy - evolution of a technique that facilitates awake neurological testing. Br J Anaesth 2003;90:161-5.
34. Weiss FR, Schwartz R. Anaesthesia for awake craniotomy. Can J Anaesth 1993;40:1003.
35. Danks RA, Rogers M, Aglio LS, Gugino LD, Black PM. Patient tolerance of craniotomy performed with the patient under local anesthesia and monitored conscious sedation. Neurosurgery 1998;42:28-36.
36. Gebhard RE, Berry J, Maggio WW, Gollas A, Chelly JE. The successful of regional anesthesia to prevent involuntary movements in a patient undergoing awake craniotomy. Anesth Analg 2000;91:1230-1.
37. Keifer JC, Dentchev D, Little K, Warner DS, Friedman AH, Borel CO. A retrospective analysis of a remifentanil/propofol general anesthetic for craniotomy before awake functional brain mapping. Anesth Analg 2005;101:502-8.
38. Audu PB, Loomba N. Use of cuffed oropharyngeal airway (COPA) for awake intracranial surgery. J Neurosurg Anesthesiol 2004;16:144-6.
39. Tijero T, Ingelmo I, García-Trapero J, Puig A. Usefulness of monitoring brain tissue oxygen pressure during awake craniotomy tumor resection. J Neurosurg Anesthesiol 2002;14:149-52.
40. Tobias JD, Jimenez DF. Anaesthetic management during awake craniotomy in a 12-year-old boy. Paediatr Anaesth 1997;7:341-4.
41. Tongier KW, Joshi GP, Landers DF, Mickey B. Use of laryngeal mask airway during awake craniotomy for tumor resection. J Clin Anesth 2000;12:592-4.
42. Schulz U, Keh D, Fritz G, Barrier C, Kerner T, Schneider GH et al. Schlaf-Wach-Schlaf technik zur wachkraniotomie. Anaesthetist 2006;55:585-98.
43. Carabine UA, Wright PMC, Moore J. Preanesthetic medication with clonidine: a dose-response study. Br J Anaesth 1991;67:79-83.
44. Chadha R, Padmanabhan V, Joseph A, Mohandas K. Oral clonidine pre-treatment fo hemodynamic stability during craniotomy. Anaesth Intensive Care 1992;20:341-4.
45. Berkenstadt H, Perel A, Hadani M, Unofrievich I, Ram Z. Monitored anesthesia care using remifentanil and propofol for awake craniotomy. J Neurosurg Anesthesiol 2001;13:246-9.
46. Yamamoto F, Kato R, Sato J, Nishino T. Anaesthesia for awake craniotomy with non-invasive positive pressure ventilation. Br J Anaesth 2003;90:382-5.
47. Caldiroli D, Bruzzone E. Awake anesthesia in neurochirurgia. Comunicazioni libere SMART; 8-10 Maggio 2002; Milano, Italia. Poster n. 30.
48. Tramèr M, Moore A, McQuay H. Propofol anaesthesia and postoperative nausea and vomiting quantitative systematic review of randomized controlled studies. Br J Anaesth 1997;78:847-55.
49. Whittle IR, Midgley S, Georges H, Pringle AM, Taylor R. Patient perceptions of awake brain tumour surgery. Acta Neurochir (Wien) 2005;147:275-7.
50. Costello TG, Cormack JR, Mather LE, LaFerlita B, Murphy MA, Harris K. Plasma levobupivacaine concentrations following scalp block in patients undergoing awake craniotomy. Br J Anaesth 2005;94:848-51.
51. Audu PB, Wilkerson C, Bartkowski R, Gingrich K, Viscusi E, Andrews D. Plasma ropivacaine levels during awake intracranial surgery. J Neurosurg Anesthesiol 2005;17: 153-5.
52. Scott DB, Lee A, Fagan D, Bowler GMR, Bloofield P, Lundh R. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 1989;69:563-9.
53. Jankovic D, Wells C. Anestesia regionale. Milano: Masson; 2002.
54. Balboni GC, Bastianini A, Brizzi E, Castorina S, Comparini L, Donato RF et al. Anatomia umana. Volume III. 3rd ed. Milano: Edizioni Ermes; 1993.
55. Murphy TM. Somatic blockade of head and neck. In: Cousins MJ, Bridenhaugh PO, editors. Neural blockade in clinical anestesia and management of pain. 3rd ed. Philadelphia: Lippincott-Raven; 1998. p. 489-514.
56. American Society of Anesthesiology House of Delegates. Position on Monitored Anesthesia Care. ASA Standards, guidelines and statements 2005. Available from: www.asahq.org/publicationAndServices/
57. Mack PF, Perrine K, Kobylarz E, Schwartz TH, Lien CA. Dexmedetomidine and neurocognitive testing in awake craniotomy. J Neurosurg Anesthesiol 2004;16:20-5.
58. Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes MD, Lee LA et al. Dexmedetomidine sedation for awake craniotomy and electrocorticography. J Neurosurg Anesthesiol 2005;17:248.
59. Hans P, Bonhomme V. Why we still use intravenous drugs as the basic regimen for neurosurgical anaesthesia. Curr Opin Anaesthesiol 2006;19:498-503.
60. Marik PE. Propofol: therapeutic indications and side-effects. Curr Pharm Des 2001;10:3639-49.
61. Soriano SG, Eldredge EA, Wang FK, Kull L, Madsen JR, Black PM et al. The effect of propofol on intraoperative electrocorticography and cortical stimulation during awake craniotomies in children. Paediatr Anaesth 2000;10:29-34.
62. Skucas AP, Artru AA. Anesthetic complications of awake craniotomies for epilepsy surgery. Anesth Analg 2006;102:882-7.
63. Beers R, Camporesi E. Remifentanil update: clinical science and utility. CNS Drugs 2004;18:1085-104.
64. Frova G, Guarino A, Petrini F, Favero R. Attrezzature per il controllo delle vie aeree. In: Frova G, Guarino A, Petrini F, Favero R, editors. Intubazione difficile e difficoltà di controllo delle vie aeree. Napoli: Madeia; 2002. p. 35-8.
65. Huncke K, Van de Wiele B, Fried I, Rubinstein EH. The asleep-awake-asleep anesthetic technique for intraoperative language mapping. Neurosurgery 1998;42:1312-6.
66. Ard JL, Bekker AY, Doyle WK. Dexmedetomidine in awake craniotomy: a technical note. Surg Neurol 2005;63:114-7.
67. Penfield W, Pasquet A. Combined regional and general anesthesia for craniotomy and cortical exploration. Anesth Analg 1954;33:145-64.
68. Hall K, Baldwin M, Norris F. Succynilcholine drip during craniotomy. Anesthesiology 1959;20:65-70.
69. Ingvar DH, Jeppsson ST, Nordstrom L. A new form of anesthesia in surgical treatment of focal epilepsy. Acta Anaesthesiol Scand 1959;3:111-21.
70. Ard J, Doyle W, Bekker A. Awake craniotomy with dexmedetomidine in pediatrics patients. J Neurosurg Anesthesiol 2003;15:263-6.
71. Bekker AY, Kaufman B, Samir H, Doyle W. The use of dexmedetomidine infusion for awake craniotomy. Anesth Amaig 2001;92:1251-3.
72. Shinokuma T, Shono S, Iwakiri S, Shigematsu K, Higa K. Awake craniotomy with propofol sedation and laryngeal mask airway: a case report. (Abstract) Masui 2002;51:529-31.
73. Songa V, Conte V, Baratta P, Magnoni S, Bello L, Stocchetti N. Remifentanil/propofol general anesthesia for functional brain mapping during tumor resection: a retrospective analysis on 63 patients. Comunicazioni libere SMART; 10-12 Maggio 2006; Milano, Italia. Poster n. 45.
74. Brimacombe J, Brain AIJ, Berry AM. Gestione dell'anestesia. In: Brimacombe J, Brain AIJ, Berry AM, editors. La maschera laringea Guida teorico-pratica. Roma, Milano: Antonio Delfino Editore; 1999. p. 66-105.
75. Brimacombe J, Tucker P, Simons S. The laryngeal mask airway for awake diagnostic bronchoscopy - a study of 200 consecutive patients. Eur J Anaesthesiol 1995;12:357-61.
76. Lee MC, Absalom AR, Menon DK, Smith HL. Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil. Anaesthesia 2006;61:32-5.
77. Chen Ch, Lin CC, Tan PP. Clinical experience of laryngeal mask airway in lateral position during anesthesia. (Abstract) Acta Anaesthesiol Sin 1995;33:31-4.
78. Pothmann W, Eckert S, Fullekrug B. Use of the laryngeal mask in difficult intubation. Anaesthetist 1993;42:644-7.
79. Gonzales J, Lombard FW, Borel CO. Pressure support mode improves ventilation in asleep-awake-asleep craniotomy. J Neurosurg Anesthesiol 2006;18:88.
80. Almeida AN, Tavares C, Tibano A, Sasaki S, Nakai Murata K, Marino R. Dexmedetomidine for awake craniotomy without laryngeal mask. Arq Neuropsiquiatr 2005;63:748-50.
81. Moore TA, Markert JM, Knowlton RC. Dexmedetomidine as rescue drug during awake craniotomy for cortical motor mapping and tumor resection. Anesth Analg 2006;102:1556-8.
82. Ramsay MAE, Savege TM, Simpson BRJ, Goodwin R. Controlled sedation with alphaxalone-alphadolone. BMJ 1974;2:656-9.
83. Mackenzie N, Grant IS. Propofol for intravenous sedation. Anaesthesia 1987;42:3-6.
84. Ghisi D, Fanelli A, Tosi M, Nuzzi M, Fanelli G. Monitored Anestesia care. Minerva Anestesiol 2005;71:533-8.
85. Bekker A, Sturaitis MK. Dexmedetomidine for neurological surgery. Neurosurgery 2005;57:1-10.
86. Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs 2000;59:263-8.
87. Hall J, Uhrich T. Sedative, amnestic and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg 2000;90:699-705.
88. Arain SR, Ruchlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg 2004;98:153-8.
89. Bustillo MA, Lazar RM, Finck AD, Fitzsimmons B, Barman MF, Pile-Spellman J et al. Dexmedetomidine may impair cognitive testing during endovascular embolization of cerebral arteriovenous malformations: a retrospective case report series. J Neurosurg Anesthesiol 2002;14:209-12.
90. Zornow MH, Maze M, Dyck JB, Shaker SL. Dexmedetomidine decreases cerebral blood flow velocity in humans. J Cereb Blood Flow Metab 1993;13:350-3.
91. Everett LL, Van Rooven IF, Warner MH, Shurtleff HA, Saneto RP, Ojemann JG. Use of dexmedetomidine in awake craniotomy in adolescents: report of two cases. Pediatr Anesth 2006;16:338-42.
92. Pasquet A. Combined regional and general anesthesia for craniotomy and cortical exploration. Part II. Anesthetic considerations. Anesth Analg 1954;33:156-7.
93. Klimek M, Verbrugge SJC, Roubos S, Van der Most E, Vincent AJ. Awake craniotomy for glioblastoma in a 9-year-old child. Anaesthesia 2004;59:607-9.
94. Sartorius CJ, Berger MS. Rapid termination of intraoperative stimulation-evoked seizures with application of cold Ringer's lactate to the cortex. Technical note. J Neurosurg 1998;88:349-51.
95. Alfonsi P. Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Drugs 2001;61:2193-205.
96. Palmon SC, Moore LE, Lundberg J, Toung T. Venous air embolism: a review. J Clin Anesth 1997;9:251-7.
97. Suarez S, Ornaque I, Fabregas N, Valero R, Carrero E. Venous air embolism during Parkinson surgery in patients with spontaneous ventilation. Anesth Analg 1999;88:793-4.
98. Balki M, Manninen PH, McGuire GP, El-Beheiry H, Bernstein M. Venous air embolism during awake craniotomy in a supine patient. Can J Anaesth 2003;50:835-8.
99. Paice JA, Cohen FL. Validity of a verbal administered numerical rating scale to measure cancer pain intensity. Cancer Nurs 1997;20:88-93.
100. Gentilini A, Schaniel C, Morari M, Bieniok C, Wymann R, Schnider T. A new paradigm for the closed-loop intraoperative administration of analgesics in humans. IEEE Trans Biomed Eng 2002;49:289-99.
101. Martinoni EF, Pfister ChA, Stadler KS, Schumacher PM, Leibundgut D, Bouillon T et al. Model-based control of mechanical ventilation: design and clinical validation. Br J Anaesth 2004;92:800-7.
102. Barazi SA, Cudlip S, Marsh H. Awake craniotomy using stealth frameless stereotaxy without rigid skull fixation. Br J Neurosurg 2006;20:43-5.
103. Taylor WAS, Thomas NWM, Wellings JA, Bell BA. Timing of postoperative intracranial haematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 1995;82:48-50.
104. Taylor MD, Bernstein M. Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg 1999;90:35-41.
105. Serletis D, Bernstein M. Prospective study of awake craniotomy used routinely and nonselectively for supratentorial tumors. J Neurosurg 2007;107:1-6.
106. Gupta DK, Chandra PS, Ojha BK, Sharma BS, Mahapatra AK, Mehta VS. Awake craniotomy versus surgery under general anesthesia for resection of intrinsic lesions of eloquent cortex - A prospective randomised study. Clin Neurol Neurosurg 2007;109:335-43.
107. Meyer FB, Bates LM, Goerss SJ, Friedman JA, Windschitl WL, Duffy JR et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc 2001;76:677-87.
108. Pang BC, Wan WH, Lee CK, Khu KJ, Ng WH. The role of surgery in high-grade gliomas - Is surgical resection justified? A review of the current knowledge. Ann Acad Med Singapore 2007;36:358-63.
109. Tharin S, Golby A. Functional brain mapping and its applications to neurosurgery. Neurosurgery 2007;60:185-202.
110. Maira G. Chirurgia dei tumori cerebrali primitivi. Neurol Sci 2003;24:584-7.