A RETROSPECTIVE STUDY OF 26 CASES OF ANAESTHESIA FOR AWAKE CRANIOTOMY
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 1
Abstract
Background: Awake craniotomy is performed for localization and resection of epileptic focus or for resection of tumours located near the eloquent areas of brain. This study was carried out to record the cases and complications occurred in awake craniotomy in 5 years. Materials & Methods: This study was conducted in the department of anesthesia in year 2010-2015. It included 26 cases of awake craniotomy over the period of 5 years. Data pertaining to pre‑anaesthetic evaluation, intraoperative management, and post‑operative course were collected. The pre‑operative data included age, sex, weight, American Society of Anesthesiologists (ASA) physical status, airway status with Mallampati (MP) grade was also noted. Intraoperative data such as anaesthetic technique and duration of surgery was recorded. The intraoperative complications such as bradycardia, tachycardia, hypotension, and hypertension, pain, hypoxia (SpO2 ≤ 90%), tight brain, seizure, cough, and any other complications were recorded. Post‑operative data such as nausea, vomiting, seizures, fever, surgical and neurological complications, progression or occurrence of new deficits, histopathological character of lesion, and duration of Intensive Care Unit and hospital stay was also recorded. Results: Out of 26 patients, 12 were males and 14 were females. The difference was statistical non significant (P-1) The mean age of male patients was 38±2.4 years and in females was 40±1.6 years. The mean weight in males was 60.24±3.2 Kg and in females was 56.08±1.7 Kg. The difference was statistical non significant (P > 0.05). ASA status 1 was seen in 17 patients and 2 in 9 patients. Right lesions were seen in 15 patients and left lesions were seen in 11 patients. 1 case of recuurent lesions was recorded. The mean duration of surgery was 246±12.6 minutes. ICU stay days were 2.4±1.3 days. Hospital stay days were 8±4 days. Propofol and fentanyl combination was the most commonly used anaesthetic regimen to provide MAC in 20 patients (propofol‑fentanyl group). Dexmedetomidine was used for conscious sedation in 6 patients. We reported intra- operative complications such as tachycardia (1) in each group. Hypertension was the most common complication recorded with Propofol and fentanyl group while no cases was seen in dexmedetomidine group. Other complications were desaturation (2), apnea (2), movement (3), tense brain (3), shivering (2) and snoring (1) in propofol‑fentanyl group. While hypotension (1), pain (1), seizures (3) and cough was seen in dexmedetomidine group. Total number of intra – operative complications such as desaturation (2), apnea (2), movement (3), tense brain (3), shivering (2) and snoring (1), hypotension (1), pain (1), seizures (3) and 6 cases of cough was seen. Conclusion: Conscious sedation is the technique of choice for awake craniotomy. For conscious sedations, Fentanyl, propofol, and dexmedetomidine are important agents used. Case selection should be carefully done. Appropriate use of sedatives or anesthetic agents is key to the success for awake craniotomy.
Authors and Affiliations
Ashish Mittal, Mridula Agarwal
MANAGEMENT OF MILLER’S CLASS III GINGIVAL RECESSION USING FREE CONNECTIVE TISSUE GRAFTS - THE USE OF TWO DIFFERENT TECHNIQUES
Background: In recent years, dentistry not only demands functional restoration of teeth but also esthetic rehabilitation. A very common issue faced is the presence of gingival recession, which not only is unesthetic but...
Surgical Lip Repositioning: A Compelling Procedure to reduce Gingival Display
Excessive gingival display or ‘Gummy smile’ is an aesthetic concern of an individual, affecting the overall personality. It can be predictably managed by Orthognathic surgery and Orthodontic treatment. The purpose of pre...
TO COMPARE THE MICROLEAKAGE IN CAVITIES RESTORED WITH NANOHYBRID COMPOSITE BY USING THREE DIFFERENT PLACEMENT TECHNIQUES: AN IN VITRO STUDY
The aim of the study was to compare the microleakage along the margins of composite restoration in class II cavities using horizontal increment, oblique increment and bulk placement technique. Methods and Material: stand...
COMPARISON OF INTRAVENOUS AND SUBMUCOSAL DEXAMETHASONE ON POSTOPERATIVE SEQUALE FOLLOWING THIRD MOLAR SURGERY
Background: Surgical removal of third molars is a routinely performed procedure. It involves removal of hard and soft tissues leading to pain, swelling and trismus. Corticosteroids are given to reduce these post operativ...
Analysis of Malocclusion among 8-14 years Old School Children: A Cross-Sectional Study
Background: Malocclusions feature the third highest prevalence among oral pathologies, second only to tooth decay and periodontal disease. While there are evidence that certain features such as stress, traumatic deep ove...