Anesthetic Management for Awake Craniotomy Applied to Neurosurgery

Our anesthetic technique proposed for awake craniotomy is the monitored anesthesia care (MAC) technique, with patient in sedation throughout intervention. protocol involves analgo-sedation through administration of dexmedetomidine and remifentanil a continuous intravenous infusion, allowing to be sedated comfort, but contactable spontaneously breathing. Pre-surgery, pre-medicated intramuscular clonidine (2 µg/kg); it acts both as an anxiolytic adjuvant pain management improves hemodynamic stability. In operating setting, infusion target controlled (TCI) effect are started. The purpose association exploit pharmacodynamics which guarantees control respiratory drive, pharmacokinetics characterized by insensitivity drug. Post-operative management: at end surgical procedure, drugs was suspended. Wake-up associated reduced hospital costs compared performed general anesthesia, mainly due room shorter stays. Greater satisfaction benefits avoiding stay have led evolution outpatient intracranial neurosurgery.