title: [Awake craniotomy. Considerations in special situations].
abstract: Awake craniotomy was the earliest surgical procedure known, and it has become fashionable again. In the past it was used for the surgical management of intractable epilepsy, but nowadays, its indications are increasing, and it is a widely recognized technique for the resection of mass lesions involving the eloquent cortex, and for deep brain stimulation. The procedure is safe, provides excellent results, and saves money and resources. The anesthesiologist should know the principles underlying neuroanesthesia, the technique of scalp blockade, and the sedation protocols, as well as feeling comfortable with advanced airway management. The main anesthetic aim is to keep patients cooperating when required (analgesia-based anesthesia). This review attempts to summarize the most recent evidence from the clinical literature, a long as the number of patients undergoing craniotomies in the awake state are increasing, specifically in the pediatric population.
authors: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital de Torrejón, Torrejón de Ardoz, Madrid, España. Electronic address: irenesolera@telefonica.net.
authors: I
authors: I
authors: Solera Ruiz
authors: R
authors: R
authors: Uña Orejón
authors: I
authors: I
authors: Valero
authors: F
authors: F
authors: Laroche
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000493:pharmacokinetics; D019072:Antibiotic Prophylaxis; D002648:Child; D016292:Procedural Sedation; D003399:Craniotomy / Q000379:methods*; D046690:Deep Brain Stimulation / Q000379:methods; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000493:pharmacokinetics; D009294:Narcotics / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D018579:Patient Selection; D011300:Preoperative Care; D012535:Scalp; D014851:Wakefulness
chemical_list: D018712:Analgesics, Non-Narcotic; D006993:Hypnotics and Sedatives; D009294:Narcotics; D020927:Dexmedetomidine
keywords: Awake craniotomy; Awake neurosurgery; Craneotomía con el paciente despierto; Functional neurosurgery; Intraoperative neurophysiological monitoring; Monitorización neurofisiológica intraoperatoria; Neuroanestesiología; Neuroanesthesiology; Neurocirugía con el paciente despierto; Neurocirugía funcional