Tolerance of awake surgery for glioma: a prospective European Low Grade Glioma Network multicenter study

Beez, Thomas; Boge, Kira; Wager, Michel; Whittle, Ian R.; Fontaine, Denys; Spena, Giannantonio; Braun, Sebastian; Szelényi, Andrea; Bello, Lorenzo; Duffau, Hugues; Sabel, Michael

doi:10.1007/s00701-013-1759-0

Cited by 107 publications

(82 citation statements)

References 30 publications

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“…Furthermore, studies have shown that adverse effects related to anxiety and stress negatively impact patient recovery in both a physical and psychological manner. 3 Therefore, it is in everyone's best interest to ensure that patients are as relaxed and stress-free as possible, especially before and during the surgery. While many studies have investigated different means by which to keep patients in optimal condition, few studies have looked at the impact of music before, during, and after surgery.…”

Section: Discussionmentioning

confidence: 99%

Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study

Jadavji-Mithani

Venkatraghavan

Bernstein

2015

Can. J. Neurol. Sci.

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Objectives: Patients undergoing awake craniotomy may experience high levels of stress. Minimizing anxiety benefits patients and surgeons. Music has many therapeutic effects in altering human mood and emotion. Tonality of music as conveyed by composition in major or minor keys can have an impact on patients' emotions and thoughts. Assessing the effects of listening to major and minor key musical pieces on patients undergoing awake craniotiomy could help in the design of interventions to alleviate anxiety, stress and tension. Methods: Twenty-nine patients who were undergoing awake craniotomy were recruited and randomly assigned into two groups: Group 1 subjects listened to major key music and Group 2 listened to minor key compositions. Subjects completed a demographics questionnaire, a pre-and post-operative Beck Anxiety Inventory (BAI) and a semi-structured open-ended interview. Results were analyzed using modified thematic analysis through open and axial coding. Results: Overall, patients enjoyed the music regardless of the key distinctions and stated they benefitted from listening to the music. No adverse reactions to the music were found. Subjects remarked that the music made them feel more at ease and less anxious before, during and after their procedure. Patients preferred either major key or minor key music but not a combination of both. Those who preferred major key pieces said it was on the basis of tonality while the individuals who selected minor key pieces stated that tempo of the music was the primary factor. Conclusion: Overall, listening to music selections was beneficial for the patients. Future work should further investigate the effects of audio interventions in awake surgery through narrative means.RÉSUMÉ: La musique est bénéfique chez les patients qui subissent une craniotomie en état vigile : une étude qualitative. Objectifs: Une craniotomie peut provoquer un stress important chez les patients et tant les patients que les chirurgiens bénéficient d'une réduction de l'anxiété. La musique a plusieurs effets thérapeutiques sur l'humeur et les émotions chez les humains. La tonalité de la musique d'oeuvres en mode majeur et d'oeuvres en mode mineur peut avoir un impact sur les émotions et les pensées des patients. Le but de l'étude était d'évaluer les effets sur les patients d'oeuvres musicales en mode majeur et d'oeuvres en mode mineur pendant la craniotomie en état vigile afin d'aider à élaborer des interventions destinées à soulager l'anxiété, le stress et la tension. Méthode: Nous avons recruté 29 patients qui subissaient une craniotomie en état vigile. Ils ont été randomisés en deux groupes : les patients du groupe 1 écoutaient de la musique en mode majeur et ceux du groupe 2 écoutaient de la musique en mode mineur. Les sujets ont complété un questionnaire démographique, l'inventaire d'anxiété de Beck avant et après la chirurgie et une entrevue semi-structurée à questions ouvertes. Les résultats ont été analysés au moyen d'une analyse thématique modifiée, par codage ouvert et codage a...

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Section: Discussionmentioning

confidence: 99%

Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study

Jadavji-Mithani

Venkatraghavan

Bernstein

2015

Can. J. Neurol. Sci.

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“…Berger et al (21) and Duffau (22) applied DES to brain tumor surgeries, particularly low-grade glioma surgeries and concurrently carried out a large number of clinical studies in which the DES technology was applied to the location of subcortical pathways. All the aforementioned efforts have contributed outstandingly to the promotion of DES, making it one of the essential techniques in the functional area surgery of neurosurgery (23)(24)(25)(26). In 2002, Wang (Guangzhou, China) applied DES to the surgery of brain functional area lesions, and following four periods of nationwide study and training, this technology has gradually been accepted and promoted by neurosurgeons in China (11,12).…”

Section: Discussionmentioning

confidence: 99%

Glioma localization and excision using direct electrical stimulation for language mapping during awake surgery

Bai

Wang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to investigate the method and significance of the application of direct electrical stimulation (DES) to the brain mapping of language functions during glioma surgery. A retrospective analysis of clinical data was performed for 91 cases of brain functional area glioma surgery under DES from January 2003 until January 2012. Following cortical electrical stimulation, 88 patients exhibited seizures involving facial or hand movements and 91 cases experienced language disorders such as counting interruption, naming errors or anomia. The most commonly observed areas of counting interruption were distributed on the posterior part of the left anterior central gyrus (47.7%), the operculum of the left inferior frontal gyrus (24.4%) and the triangular part of the left inferior frontal gyrus (12.8%). Postoperative magnetic resonance imaging demonstrated that overall excision was achieved in 53 cases and sub-overall excision was performed in 31 cases. A total of 42 cases (46.2%) exhibited no postoperative neurological dysfunction, 39 cases (42.9%) exhibited brief language dysfunction, 27 cases (29.7%) experienced brief limb movement disorder, and one case appeared to have permanent neurological dysfunction. DES was indicated to be a reliable and noninvasive method for the intraoperative positioning of language areas, and was able to resect gliomas in the language area with maximal safety.

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“…Zur Verbesserung der Qualität der Betreuung ist eine postoperative Visite auch durch den Anästhe-sisten ausgesprochen sinnvoll. Hilfreich für die postoperative Befragung kann der Fragebogen des European Low Grade Glioma Network sein [1].…”

Section: Anästhesieunclassified

Anästhesiologisches Management zur Wachkraniotomie

et al. 2014

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Awake craniotomy is indicated in deep brain stimulation (DBS) for treatment of certain movement disorders, such as in Parkinson disease patients or in the surgery of brain tumors in close vicinity to the language area. The standard procedure is the asleep-awake-asleep technique where general anesthesia or analgosedation is intermittently interrupted for neurological testing. In DBS the intraoperative improvement of symptoms, stereotactic navigation and microelectrode reading guide to the optimal position. In brain tumor resection, reversible functional impairments during electrical stimulation on the brain surface (brain mapping) show the exact individual position of eloquent or motoric areas that should be protected.The anesthesiology procedures used are very variable. It is a balancing act between overdosing of anesthetics with impairment of respiration and alertness and underdosing with pain, strain and stress for the patient. For the asleep-awake-asleep technique high acceptance but also frequent and partly severe complications have been reported. The psychological stress for the patient can be immense. Obviously, a feeling of being left alone and being at someone's mercy is not adequately treated by drugs and performance of the neurological tests is undoubtedly better and more reliable with less pharmacological impairment. Cranial nerve blocks can reduce the amount of anesthetics as they provide analgesia of the scalp more efficiently than local infiltration. With these nerve blocks, a strong therapeutic relationship and a specific communication, sedatives can be avoided and the need for opioids markedly reduced or abolished. The suggestive communication promotes for instance dissociation to an inner safe refuge, as well as reframing of disturbing noises and sensations. Each of the methods applied for awake craniotomy can profit from the principles of this awake-awake-awake technique.

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Tolerance of awake surgery for glioma: a prospective European Low Grade Glioma Network multicenter study

Cited by 107 publications

References 30 publications

Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study

Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study

Glioma localization and excision using direct electrical stimulation for language mapping during awake surgery

Anästhesiologisches Management zur Wachkraniotomie

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