Combination of Continuous Dexmedetomidine Infusion with Titrated Ultra-Low-Dose Propofol-Fentanyl for an Awake Craniotomy.
An awake craniotomy is a continuously evolving technique used for the resection of brain tumours from the eloquent cortex. We report a 29-year-old male patient who presented to the Khoula Hospital, Muscat, Oman, in 2016 with a two month history of headaches and convulsions due to a space-occupying brain lesion in close proximity with the left motor cortex. An awake craniotomy was conducted using a scalp block, continuous dexmedetomidine infusion and a titrated ultra-low-dose of propofolfentanyl. The patient remained comfortable throughout the procedure and the intraoperative neuropsychological tests, brain mapping and tumour resection were successful. This case report suggests that dexmedetomidine in combination with titrated ultra-low-dose propofolfentanyl are effective options during an awake craniotomy, ensuring optimum sedation, minimal disinhibition and a rapid recovery. To the best of the authors' knowledge, this is the first awake craniotomy conducted successfully in Oman.
Departments of Anaesthesia & Intensive Care, Khoula Hospital, Muscat, Oman.
Samaresh
S
Das
Neurosurgery, Khoula Hospital, Muscat, Oman.
Ali
A
Al-Mashani
Departments of Anaesthesia & Intensive Care, Khoula Hospital, Muscat, Oman.
Neelam
N
Suri
Neurosurgery, Khoula Hospital, Muscat, Oman.
Neeraj
N
Salhotra
Departments of Anaesthesia & Intensive Care, Khoula Hospital, Muscat, Oman.
Nilay
N
Chatterjee
Anesthesia; Case Report; Craniotomy; Dexmedetomidine; Fentanyl; Oman; Propofol