> Details

D’Onofrio, Grazia; Izzi, Antonio; Manuali, Aldo; Bisceglia, Giuliano; Tancredi, Angelo; Marchello, Vincenzo; Recchia, Andreaserena; Tonti, Maria Pia; Icolaro, Nadia; Fazzari, Elena; Carotenuto, Vincenzo; De Bonis, Costanzo De; Savarese, Luciano; Gorgoglione, Leonardo Pio; Del Gaudio, Alfredo Del

Anesthetic Management for Awake Craniotomy Applied to Neurosurgery

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Anesthetic Management for Awake Craniotomy Applied to Neurosurgery
  • Contributor: D’Onofrio, Grazia; Izzi, Antonio; Manuali, Aldo; Bisceglia, Giuliano; Tancredi, Angelo; Marchello, Vincenzo; Recchia, Andreaserena; Tonti, Maria Pia; Icolaro, Nadia; Fazzari, Elena; Carotenuto, Vincenzo; De Bonis, Costanzo De; Savarese, Luciano; Gorgoglione, Leonardo Pio; Del Gaudio, Alfredo Del
  • Published: MDPI AG, 2023
  • Published in: Brain Sciences, 13 (2023) 7, Seite 1031
  • Language: English
  • DOI: 10.3390/brainsci13071031
  • ISSN: 2076-3425
  • Origination:
  • Footnote:
  • Description: Our anesthetic technique proposed for awake craniotomy is the monitored anesthesia care (MAC) technique, with the patient in sedation throughout the intervention. Our protocol involves analgo-sedation through the administration of dexmedetomidine and remifentanil in a continuous intravenous infusion, allowing the patient to be sedated and in comfort, but contactable and spontaneously breathing. Pre-surgery, the patient is pre-medicated with intramuscular clonidine (2 µg/kg); it acts both as an anxiolytic and as an adjuvant in pain management and improves hemodynamic stability. In the operating setting, dexmedetomidine in infusion and remifentanil in target controlled infusion (TCI) for effect are started. The purpose of the association is to exploit the pharmacodynamics of dexmedetomidine which guarantees the control of respiratory drive, and the pharmacokinetics of remifentanil characterized by insensitivity to the drug. Post-operative management: at the end of the surgical procedure, the infusion of drugs was suspended. Wake-up craniotomy is associated with reduced hospital costs compared to craniotomy performed in general anesthesia, mainly due to reduced costs in the operating room and shorter hospital stays. Greater patient satisfaction and the benefits of avoiding hospital stay have led to the evolution of outpatient intracranial neurosurgery.
  • Access State: Open Access