Wrede Karsten H, Stieglitz Lennart H, Fiferna Antje, Karst Matthias, Gerganov Venelin M, Samii Madjid, von Gösseln Hans-Henning, Lüdemann Wolf O
University Hospital Essen, Department of Neurosurgery, Hufelandstrasse 55, 45147 Essen, Germany.
Clin Neurol Neurosurg. 2011 Dec;113(10):880-4. doi: 10.1016/j.clineuro.2011.06.010. Epub 2011 Jul 23.
The aim of this study was to objectively assess the patients' acceptance for awake craniotomy in a group of neurosurgical patients, who underwent this procedure for removal of lesions in or close to eloquent brain areas.
Patients acceptance for awake craniotomy under local anesthesia and conscious sedation was assessed by a formal questionnaire (PPP33), initially developed for general surgery patients. The results are compared to a group of patients who had brain surgery under general anesthesia and to previously published data.
The awake craniotomy (AC) group consisted of 37 male and 9 female patients (48 craniotomies) with age ranging from 18 to 71 years. The general anesthesia (GA) group consisted of 26 male and 15 female patients (43 craniotomies) with age ranging from 26 to 83 years. All patients in the study were included in the questionnaire analysis. In comparison to GA the overall PPP33 score for AC was higher (p=0.07), suggesting better overall acceptance for AC. The subscale scores for AC were also significantly better compared to GA for the two subscales "postoperative pain" (p=0.02) and "physical disorders" (p=0.01) and equal for the other 6 subscales. The results of the overall mean score and the scores for the subscales of the PPP33 questionnaire verify good patients' acceptance for AC.
Previous studies have shown good patients' acceptance for awake craniotomy, but only a few times using formal approaches. By utilizing a formal questionnaire we could verify good patient acceptance for awake craniotomy for the treatment of brain tumors in or close to eloquent areas. This is a novel approach that substantiates previously published experiences.
本研究旨在客观评估一组神经外科患者对清醒开颅手术的接受程度，这些患者因切除位于明确脑区或其附近的病变而接受该手术。
通过一份最初为普通外科患者设计的正式问卷（PPP33）评估患者对局部麻醉和清醒镇静下清醒开颅手术的接受程度。将结果与一组接受全身麻醉下脑手术的患者以及先前发表的数据进行比较。
清醒开颅手术（AC）组包括37名男性和9名女性患者（共48例开颅手术），年龄在18至71岁之间。全身麻醉（GA）组包括26名男性和15名女性患者（共43例开颅手术），年龄在26至83岁之间。研究中的所有患者均纳入问卷分析。与全身麻醉相比，清醒开颅手术的总体PPP33评分更高（p = 0.07），表明对清醒开颅手术的总体接受度更好。在“术后疼痛”（p = 0.02）和“身体不适”（p = 0.01）这两个子量表方面，清醒开颅手术的子量表评分也显著优于全身麻醉，在其他6个子量表方面两者相当。PPP33问卷的总体平均分和子量表评分结果证实患者对清醒开颅手术接受度良好。
先前的研究表明患者对清醒开颅手术接受度良好，但仅有少数研究采用了正式方法。通过使用正式问卷，我们能够证实患者对清醒开颅手术治疗位于明确脑区或其附近的脑肿瘤接受度良好。这是一种新方法，证实了先前发表的经验。
