ANESTHETIC MANAGEMENT FOR AWAKE CRANIOTOMY PATIENT WITH MENINGIOMA UNDERWENT BRAIN TUMOR RESECTION IN ULIN HOSPITAL BANJARMASIN

Abstract

The awake craniotomy technique was introduced for surgical treatment of epilepsy, and subsequently has been used in the resection of the brain tumour involving functional cortex and supratentorial tumour, regardless of the involvement of the cortex 1,2. The main advantage for the awake neurosurgical approach is to facilitate intraoperative electrocorticography and cortical mapping for the accurate identification of brain areas which control motor function and speech 3 . The primary goal of the anaesthetist is to make the operation safe and effective while reducing the psychophysical distress of the patient 4 . Several anaesthetic methods can be used for awake craniotomy: monitored anaesthesia cared (MAC), Asleep-awake-asleep technique (AAA), and asleep-awake (AA) methods 3-7 . Dexmedetomidine appears to be of increasing interest because it seems to provide sedation closer to natural sleep, it gives anxiolysis and analgesia, decreases the need for opioids and antihypertensive drugs and it does not interfere with respiratory function5 . Complications of awake craniotomies include seizures, swelling of the brain, nausea and vomiting, decreased level of consciousness, neurological deficit, pain and loss of patient cooperation 3 .