title: Dexmedetomidine and Mannitol for Awake Craniotomy in a Pregnant Patient.
abstract: We describe the use of dexmedetomidine for an awake neurosurgical procedure in a pregnant patient and quantify the effect of mannitol on intrauterine volume. A 27-year-old woman underwent a craniotomy, with intraprocedural motor and speech mapping, at 20 weeks of gestation. Sedation was maintained with dexmedetomidine. Mannitol at 0.25 g/kg IV was administered to control brain volume during surgery. Internal uterine volume was estimated at 1092 cm before surgery and decreased to 770 and 953 cm at 9 and 48 hours, respectively, after baseline assessment. No adverse maternal or fetal effects were noted during the intraoperative period or up to 48 hours postoperatively.
authors.affiliation: From the Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota; and Department of Neurosurgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Handlogten
authors.forename: Emily E
authors.initials: EE
authors.lastname: Sharpe
authors.forename: Brian C
authors.initials: BC
authors.lastname: Brost
authors.forename: Ian F
authors.initials: IF
authors.lastname: Parney
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Pasternak
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008353:Mannitol / Q000008:administration & dosage; D016343:Monitoring, Intraoperative / Q000379:methods; D009043:Motor Activity; D009929:Organ Size; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013060:Speech; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014599:Uterus / Q000033:anatomy & histology / Q000187:drug effects; D014851:Wakefulness
chemical_list: D006993:Hypnotics and Sedatives; D008353:Mannitol; D020927:Dexmedetomidine