Anesthésie pour craniotomie éveillé: guide pratique pour le praticien occasionnel

Translated title of the contribution: Anesthesia for awake craniotomy: a how-to guide for the occasional practitioner

Lingzhong Meng, David L. McDonagh, Mitchel S. Berger, Adrian W. Gelb

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Awake craniotomy (AC), defined as the performance of at least part of an open cranial procedure with the patient awake, has been tied to beneficial outcomes compared with similar surgery under general anesthesia. Improved anesthetic techniques have made a major contribution to the increasing popularity of AC. However, the heterogeneity of practice among institutions doing large numbers of ACs raises questions (often among those who only occasionally perform AC – i.e., practitioners in low-volume AC institutions) as to the ideal anesthetic technique for AC. The procedure presents a variety of decision-making dilemmas, the origins of which are the varying institutional preferences, lack of quality evidence, and several practice controversies. Evidence-based data that support a single anesthetic algorithm for AC are sparse. In this narrative review, the technical nuances of 13 aspects of anesthetic care for AC are discussed based on institutional preferences and available evidence, and the various controversies and research priorities are discussed. The skills, experience, and commitment of both the surgeon and the anesthesiologist are large variables that are likely more important than what the literature suggests about “best” techniques for AC. Optimizing patient outcome is the fundamental goal of the anesthesiologist.

Translated title of the contributionAnesthesia for awake craniotomy: a how-to guide for the occasional practitioner
Original languageFrench
Pages (from-to)517-529
Number of pages13
JournalCanadian Journal of Anesthesia
Volume64
Issue number5
DOIs
StatePublished - May 1 2017

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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