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ASSESSMENT OF PATIENT SATISFACTION WITH AWAKE CRANIOTOMY

Department of Anesthesia, The Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8.

INTRODUCTION:

Awake craniotomy with brain mapping allows for optimal resection of brain tumors close to eloquent cortex. Different anesthetic techniques have been described. The aim of this study was to assess the satisfaction of patients with awake craniotomy performed completely under local anesthesia and conscious sedation.

METHODS:

With IRB approval we prospectively assessed the subjective experience of awake craniotomy by conducting interviews at 1, 4 and 24 hr postoperatively. Patients were questioned about recall of procedure, intraoperative pain, discomfort and anxiety, and overall satisfaction. Anesthetic agents used, perioperative complications, discharge time and outcome were documented.

RESULTS:

Thirty-two patients (16 males, 16 females) with mean ±SD age 47±13yr, weight 76±17kg were studied. All patients had Glasgow Coma Score of 15. Local anesthesia (bupivacaine) was used for insertion of head pins and incision. Conscious sedation included 2.2±1.8mg midazolam (n=32), 599±583mg propofol (n=30), 180±137ug fentanyl (n=31), and 0.25±0.15mg remifentanil (n=13). Duration of procedure was 193±95min. 11 patients (34%) were discharged same day, remainder at 2.2±2.2days. Satisfaction results are in table. At 24 hours 91% of patients were completely satisfied with their experience. For most patients there was consistency in their responses over the 24 hours.

Awake craniotomy with local anesthesia and conscious sedation is an acceptable technique that provides good patient satisfaction.

REFERENCE

J Neurosurg Anesthesiol 2001;13:246[Medline]

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