Awake neurosurgery: An update

V. Conte, P. Baratta, P. Tomaselli, V. Songa, L. Magni, N. Stocchetti

Research output: Contribution to journalArticle

Abstract

Intraoperative brain mapping has the goal of aiding with maximal surgical resection of brain tumors while minimizing functional sequelae. Retrospective randomized studies on large populations have shown that this technique can optimize the surgical approach while reducing postoperative morbidity. During direct electrical stimulation of the language areas adjacent to the tumor, the patient should be collaborative and be able to speak to participate in language testing. Different anesthesiological protocols have been proposed to allow intraoperative brain mapping, which range from local anesthesia to conscious sedation or general anesthesia, with or without airway instrumentation. The most common intraoperative complications are seizure, respiratory depression, and patients' stress and discomfort. Since awake craniotomy carries both benefits and potential risks, the following factors are crucial in the management of patients: 1) careful selection of the patients and 2) communication between the anesthesiological and surgical teams. To date, there remains no consensus about the optimal anesthesiological regimen to use. Only prospective, multicentre randomized studies focused on evaluating the role of different anesthesiological techniques on intraoperative monitoring, postoperative deficits, and intraoperative complications can answer the question of which anesthesiological approach should be chosen when intraoperative brain mapping is requested.

Original languageEnglish
Pages (from-to)289-292
Number of pages4
JournalMinerva Anestesiologica
Volume74
Issue number6
Publication statusPublished - Jun 2008

Fingerprint

Brain Mapping
Neurosurgery
Intraoperative Complications
Language
Conscious Sedation
Intraoperative Monitoring
Craniotomy
Local Anesthesia
Brain Neoplasms
Respiratory Insufficiency
General Anesthesia
Patient Selection
Electric Stimulation
Multicenter Studies
Consensus
Seizures
Retrospective Studies
Communication
Morbidity
Population

Keywords

  • Anesthesia
  • Brain mapping
  • Brain neoplasms

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Conte, V., Baratta, P., Tomaselli, P., Songa, V., Magni, L., & Stocchetti, N. (2008). Awake neurosurgery: An update. Minerva Anestesiologica, 74(6), 289-292.

Awake neurosurgery : An update. / Conte, V.; Baratta, P.; Tomaselli, P.; Songa, V.; Magni, L.; Stocchetti, N.

In: Minerva Anestesiologica, Vol. 74, No. 6, 06.2008, p. 289-292.

Research output: Contribution to journalArticle

Conte, V, Baratta, P, Tomaselli, P, Songa, V, Magni, L & Stocchetti, N 2008, 'Awake neurosurgery: An update', Minerva Anestesiologica, vol. 74, no. 6, pp. 289-292.
Conte V, Baratta P, Tomaselli P, Songa V, Magni L, Stocchetti N. Awake neurosurgery: An update. Minerva Anestesiologica. 2008 Jun;74(6):289-292.
Conte, V. ; Baratta, P. ; Tomaselli, P. ; Songa, V. ; Magni, L. ; Stocchetti, N. / Awake neurosurgery : An update. In: Minerva Anestesiologica. 2008 ; Vol. 74, No. 6. pp. 289-292.
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