A ANESTHESIA FOR AWAKE CRANIOTOMY – HOW DO WE PERFORM IT?

Anesthesia for awake craniotomy

  • Tijana Nastasovic, MD, PhD Klinicki centar Srcije, Centar za anesteziologiju i reanimatologiju, Odeljenje anesteziologije i reanimatologije na Klinici za neurohirurgiju https://orcid.org/0000-0001-6147-7070
  • Nevena Savic, MD School of Medicine, Belgrade, Serbia
  • Igor Lazic, MD University Clinical Center of Serbia, Department of Anesthesiology and Resuscitation on Neurosurgery Clinic, School of Medicine, Belgrade, Serbia
  • Tjasa Ivosevic, MD, PhD University Clinical Center of Serbia, Department of Anesthesiology and Resuscitation on ENT and Maxillofacial Clinic, School of Medicine, Belgrade, Serbia https://orcid.org/0000-0002-4964-6916
  • Ivan Bogdanovic, MD University Clinical Center of Serbia, Neurosurgery Clinic, School of Medicine, Belgrade, Serbia https://orcid.org/0000-0003-0055-5201
  • Rosanda Ilic, Md, PhD University Clinical Center of Serbia, Neurosurgery Clinic, School of Medicine, Belgrade, Serbia https://orcid.org/0000-0002-4883-7999
  • Filip Milisavljevic, MD University Clinical Center of Serbia, Neurosurgery Clinic, Belgrade, Serbia https://orcid.org/0000-0003-4737-9890
DOI: https://doi.org/10.5937/medi57-50916
Keywords: awake craniotomy, anesthesia, speech mapping, „awake-awake-awake“, „asleep-awake-asleep“

Abstract


Awake craniotomy is a neurosurgical procedure that is used for the safe removal of intracranial lesions near Broca’s and Wernicke’s speech areas. During it, speech mapping is done. Its use demands anesthesia for awake craniotomy, which includes different possibilities for the management of anesthesia with awake patients at the moment of tumor removal. There are two widely accepted concepts: „awake-awake-awake“, when the patient is consciously sedated („awake“) all the time during surgery, with lighter or deeper sedation (monitored anesthesia care), or „asleep-awake-asleep“, when the patient is introduced into general endotracheal anesthesia while opening the skull, but awake during lesion removal and asleep during closure. Our protocol is a form of „asleep-awake“ concept, with general endotracheal anesthesia for craniotomy and awake patients during and after lesion removal (including skull closure).

 

Author Biographies

Tijana Nastasovic, MD, PhD, Klinicki centar Srcije, Centar za anesteziologiju i reanimatologiju, Odeljenje anesteziologije i reanimatologije na Klinici za neurohirurgiju

Department of Anesthesiology and Resuscitation, Neurosurger Clinic 2007.- attending physician; -2004.-specialist in Anesthesiology and Resuscitation

School of Medicine, Belgrade, Serbia, 2017- PhD

School of Medicine, Belgrade, Serbia, 2018- Assisstant Professor

School of Medicine, Belgrade, Serbia, 2022-Scientific Associate

Nevena Savic, MD, School of Medicine, Belgrade, Serbia

She wrote an article as a student, meanwhile she graduated

Igor Lazic, MD, University Clinical Center of Serbia, Department of Anesthesiology and Resuscitation on Neurosurgery Clinic, School of Medicine, Belgrade, Serbia

Igor Lazic is Assisstant Professor on Department of Surger and Anesthesiology, field of Anesthesiology and Resuscitation. He works as anesthesiologist on Neurosurger Clinic, UCCS, Belgrade.

Tjasa Ivosevic, MD, PhD, University Clinical Center of Serbia, Department of Anesthesiology and Resuscitation on ENT and Maxillofacial Clinic, School of Medicine, Belgrade, Serbia

Tjasa Ivosevic, MD, PhD is Assisstant Professor on School of Medicine, Belgrade. She is anesthesiologist on Clinic for ENT and Maxillofacial Surger, UCCS.

Ivan Bogdanovic, MD, University Clinical Center of Serbia, Neurosurgery Clinic, School of Medicine, Belgrade, Serbia

Neurosurgeon, Assisstant Professor

Rosanda Ilic, Md, PhD, University Clinical Center of Serbia, Neurosurgery Clinic, School of Medicine, Belgrade, Serbia

Neurosurgeon, Associate Professor

Filip Milisavljevic, MD, University Clinical Center of Serbia, Neurosurgery Clinic, Belgrade, Serbia

Resident in neurosurgery

Published
2024/08/26
Issue
Vol. 57 No. 3 (2024): Medicinska istraživanja
Section
Članci