title: Comparison of Conscious Sedation and Asleep-Awake-Asleep Techniques for Awake Craniotomy.
abstract: Since awake craniotomy (AC) has become a standard of care for supratentorial tumour resection, especially in the motor and language cortex, determining the most appropriate anaesthetic protocol is very important. The aim of this retrospective study is to compare the effectiveness of conscious sedation (CS) to "awake-asleep-awake" (AAA) techniques for supratentorial tumour resection. Forty-two patients undergoing CS and 22 patients undergoing AAA were included in the study. The primary endpoint was to compare the CS and AAA techniques with respect to intraoperative pain and agitation in patients undergoing supratentorial tumour resection. The secondary endpoint was comparison of the other intraoperative complications. This study results show that the incidence of intraoperative agitation and seizure were lower in the AAA group than in the CS group. Intraoperative blood pressures were significantly higher in the CS group than in the AAA group during the pinning and incision, but the level of blood pressures did not need antihypertensive treatment. Otherwise, blood pressures were significantly higher in the AAA group than in the CS group during the neurological examination and the severity of hypertension needed statistically significant more antihypertensive treatment in the AAA group. As a result of hypertension, the amount of intraoperative bleeding was higher in the AAA group than in the CS group. In conclusion, the AAA technique may provide better results with respect to agitation and seizure, but intraoperative hypertension needed a vigilant follow-up especially in the wake-up period.
authors: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: korkmazdilmen@gmail.com.
authors: Ozlem Korkmaz
authors: OK
authors: Dilmen
authors: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: erenfat@yahoo.com.
authors: Eren Fatma
authors: EF
authors: Akcil
authors: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: avahapoguz@gmail.com.
authors: Abdulvahap
authors: A
authors: Oguz
authors: University of Istanbul, Cerrahpasa School of Medicine, Department of Biostatistics, Turkey. Electronic address: ertem@istanbul.edu.tr.
authors: Hayriye
authors: H
authors: Vehid
authors: University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care, Turkey. Electronic address: ytunali@yahoo.com.
authors: Yusuf
authors: Y
authors: Tunali
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery; D016292:Procedural Sedation / Q000379:methods* / Q000592:standards; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000601:surgery; D014851:Wakefulness
keywords: Awake craniotomy; Conscious sedation; Supratentorial tumour