Sheshadri Veena, Chandramouli B A
Vikram Hospital, 71/1, Miller's Road, Bengaluru, Karnataka 560052, India.
Vikram Hospital, 71/1, Miller's Road, Bengaluru, Karnataka 560052, India.
J Clin Anesth. 2016 Aug;32:199-202. doi: 10.1016/j.jclinane.2016.03.009. Epub 2016 Apr 20.
Resection of lesions near the eloquent cortex of brain necessitates awake craniotomy to reduce the risk of permanent neurologic deficits during surgery. There are limited reports of anesthetic management of awake craniotomy in pediatric patients. This report is on use of dexmedetomidine sedation for awake craniotomy in a 11-year-old child, without any airway adjuncts throughout the procedure. Dexmedetomidine infusion administered at a dosage of 0.2 to 0.7μg kg(-1) h(-1) provided adequate sedation for the entire procedure. There were no untoward incidents or any interference with electrocorticography, intraoperative stimulation, and functional mapping. Adequate preoperative visits and counseling of patient and parents regarding course and nature of events along with well-planned intraoperative management are of utmost importance in a pediatric age group for successful intraoperative awake craniotomy.
切除靠近脑功能区皮质的病变需要在清醒状态下开颅，以降低手术期间永久性神经功能缺损的风险。关于小儿患者清醒开颅麻醉管理的报道有限。本报告介绍了在一名11岁儿童清醒开颅手术中使用右美托咪定镇静，整个手术过程未使用任何气道辅助设备。以0.2至0.7μg·kg⁻¹·h⁻¹的剂量输注右美托咪定，为整个手术过程提供了充分的镇静。没有发生不良事件，也没有对皮质脑电图、术中刺激和功能定位产生任何干扰。对于小儿年龄组，术前对患者及其父母进行充分的访视和咨询，告知手术过程和性质，并进行精心规划的术中管理，对于成功实施术中清醒开颅手术至关重要。
