Awake surgery in neurooncology. Part 1. Anesthesia features, selection of patients, method’s advantages and drawbacks

Abstract

To reduce patient’s discomfort during awake surgery convenient patient’s position on operation table is applied, comfort temperature and close contact to psychologist are supported. Anesthesiologic features of awake surgery include regional and conduction anesthesia of scalp nerves, light sedation, attentive control over air ways and dural infiltration with anesthetics. Keeping patient’s consciousness during surgical approach increases reliability of intraoperative tests but demands more thorough anesthesia and control over patient’s condition.Neuromonitoring in awake patient increases extent of gliomas’ resection and decreases risk of permanent neurological disorders.Risks of awake surgery are devided into respiratory, neurological, cardiological and psychological. Intraoperative seizures arise in 3–12 % of cases.Most of the patients rate awake surgery positively and agree to repeated similar operations.