Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic s...

Introduction It is now possible to map areas of proposed brain resection. If these are near speech and motor regions, intraoperative stimulation may prevent permanent injury while allowing a more complete resection (1). This requires an awake, cooperative patient to assess motor and verbal response. We describe the first reported case of an awake craniotomy, in an adolescent, using only a nasal...

BACKGROUND Based upon the surgical location and indication, including redundant regions, eloquent areas, deep brain stimulation, and epilepsy foci, some patients will benefit from an awake craniotomy, which allows completion of neurocognitive testing during the intra-operative period. This paper suggests patient selection criteria through a new decision algorithm. METHODS We completed a retro...

Objectives At the completion of this course, the reader should be able to: 1. Identify the anatomical structures and functions of the “eloquent” cerebral cortex. 2. Understand the need for careful planning and implementation of anesthetic care in a patient undergoing an awake craniotomy. 3. List and discuss the components of a regional scalp block and associated caveats. 4. Describe the potenti...

BACKGROUND AND OBJECTIVES Some intracranial procedures are achievable with patients awake, however, there are challenges ranging from patient compliance to homeostasis. The aim of this study is to present a case of intracranial surgery for removal of a tumor in the left parietal lobe with the patient awake during the procedure. CASE REPORT After patient selection and psychological preparation...

This technical report disrobes the first case in Intra-operative Magnatic Resonance Imaging operating theatre (iMRI OT) (BrainSuite), of Awake Craniotomy. The procedure was for frontal lobe glioma excision in 24 y. old man. He was scheduled to undergo eloquent cortex language mapping intra-operatively. He was motivated and was excited to see the operating theatre. He requested to take his photo...

To JNA Readers: The success of surgeries such as awake craniotomy depends much on the education status and the cooperation of the patient. All efforts should be made to relieve the anxiety of the patients during the perioperative period. Inadequate bowel preparation inciting the urge to defecate once the patient is inside the operating room can be a distressing factor both for the patient and t...