title: Patient acceptance of awake craniotomy.
abstract: OBJECTIVE
  The aim of this study was to objectively assess the patients' acceptance for awake craniotomy in a group of neurosurgical patients, who underwent this procedure for removal of lesions in or close to eloquent brain areas.
  
  
  METHODS
  Patients acceptance for awake craniotomy under local anesthesia and conscious sedation was assessed by a formal questionnaire (PPP33), initially developed for general surgery patients. The results are compared to a group of patients who had brain surgery under general anesthesia and to previously published data.
  
  
  RESULTS
  The awake craniotomy (AC) group consisted of 37 male and 9 female patients (48 craniotomies) with age ranging from 18 to 71 years. The general anesthesia (GA) group consisted of 26 male and 15 female patients (43 craniotomies) with age ranging from 26 to 83 years. All patients in the study were included in the questionnaire analysis. In comparison to GA the overall PPP33 score for AC was higher (p=0.07), suggesting better overall acceptance for AC. The subscale scores for AC were also significantly better compared to GA for the two subscales "postoperative pain" (p=0.02) and "physical disorders" (p=0.01) and equal for the other 6 subscales. The results of the overall mean score and the scores for the subscales of the PPP33 questionnaire verify good patients' acceptance for AC.
  
  
  CONCLUSIONS
  Previous studies have shown good patients' acceptance for awake craniotomy, but only a few times using formal approaches. By utilizing a formal questionnaire we could verify good patient acceptance for awake craniotomy for the treatment of brain tumors in or close to eloquent areas. This is a novel approach that substantiates previously published experiences.
authors.affiliation: University Hospital Essen, Department of Neurosurgery, Hufelandstrasse 55, 45147 Essen, Germany. karsten@dr-wrede.com
authors.forename: Karsten H
authors.initials: KH
authors.lastname: Wrede
authors.forename: Lennart H
authors.initials: LH
authors.lastname: Stieglitz
authors.forename: Antje
authors.initials: A
authors.lastname: Fiferna
authors.forename: Matthias
authors.initials: M
authors.lastname: Karst
authors.forename: Venelin M
authors.initials: VM
authors.lastname: Gerganov
authors.forename: Madjid
authors.initials: M
authors.lastname: Samii
authors.forename: Hans-Henning
authors.initials: HH
authors.lastname: von Gösseln
authors.forename: Wolf O
authors.initials: WO
authors.lastname: Lüdemann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D003399:Craniotomy / Q000379:methods* / Q000523:psychology*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D010342:Patient Acceptance of Health Care; D011182:Postoperative Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014851:Wakefulness; D055815:Young Adult