title: [Anesthetic considerations for awake craniotomy: case report].
abstract: OBJECTIVE
  The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and lesser sequelae. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose.
  
  
  METHODS
  In this case, interaction with the patient during brain tumor resection enabled a broad approach of the tumor lesion, limited by deficits in speech and naming observed during surgical manipulation, avoiding major consequences. The chosen technique was deepening of general anesthesia during surgical times of most painful stimulus with intraoperative awakening of the patient.
  
  
  CONCLUSIONS
  Patient selection, an exhaustive explanation of the procedure to him, and the selection of drugs are crucial for a successful procedure. Laryngeal mask is useful in times requiring greater depth and anesthetic ventilation control, primarily in situations where endotracheal intubation may be hindered by the position. The continuous infusion of remifentanil and adjuncts in the awake period associated adequate analgesia and full consciousness.
authors.affiliation: Hospital Felício Rocho, Belo Horizonte, MG, Brasil.
authors.forename: Cassiano Hamacek de
authors.initials: CH
authors.lastname: Freitas
authors.affiliation: Hospital Felício Rocho, CET, Belo Horizonte, MG, Brasil.
authors.forename: Celso Homero Santos
authors.initials: CHS
authors.lastname: Oliveira
authors.affiliation: Hospital Felício Rocho, CET, Belo Horizonte, MG, Brasil.
authors.forename: Daniel Câmara de
authors.initials: DC
authors.lastname: Rezende
authors.affiliation: Hospital Felício Rocho, Belo Horizonte, MG, Brasil; Fundação Educacional Lucas Machado (Feluma), Belo Horizonte, MG, Brasil. Electronic address: joyceromano.med@gmail.com.
authors.forename: Joyce
authors.initials: J
authors.lastname: Romano
authors.affiliation: Hospital Felício Rocho, Belo Horizonte, MG, Brasil.
authors.forename: Henrique Rodrigues Lemos
authors.initials: HRL
authors.lastname: Silva
authors.affiliation: Hospital Felício Rocho, Belo Horizonte, MG, Brasil; Fundação Educacional Lucas Machado (Feluma), Belo Horizonte, MG, Brasil.
authors.forename: Ivana Mares
authors.initials: IM
authors.lastname: Trivellato
keywords: Awake craniotomy; Craniotomia acordado; Laryngeal mask airway; Máscara laríngea; Neurocirurgia; Neurosurgery; Remifentanil