Meziane Mohammed, Elkoundi Abdelghafour, Ahtil Redouane, Guazaz Miloudi, Mustapha Bensghir, Haimeur Charki
Department of Anesthesiology and Intensive Care, Military Hospital Med V of Rabat, Faculty of Medicine and Pharmacy of Rabat, University Souissi-Med V, Rabat, Morocco.
Department of Neurosurgery, Military Hospital Med V of Rabat, Faculty of Medicine and Pharmacy of Rabat, University Souissi-Med V, Rabat, Morocco.
Pan Afr Med J. 2017 Jun 30;27:156. doi: 10.11604/pamj.2017.27.156.10249. eCollection 2017.
The awake brain surgery is an innovative approach in the treatment of tumors in the functional areas of the brain. There are various anesthetic techniques for awake craniotomy (AC), including asleep-awake-asleep technique, monitored anesthesia care, and the recent introduced awake-awake-awake method. We describe our first experience with anesthetic management for awake craniotomy, which was a combination of these techniques with scalp nerve block, and propofol/rémifentanil target controlled infusion. A 28-year-oldmale underwent an awake craniotomy for brain glioma resection. The scalp nerve block was performed and a low sedative state was maintained until removal of bone flap. During brain glioma resection, the patient awake state was maintained without any complications. Once, the tumorectomy was completed, the level of anesthesia was deepened and a laryngeal mask airway was inserted. A well psychological preparation, a reasonable choice of anesthetic techniques and agents, and continuous team communication were some of the key challenges for successful outcome in our patient.
清醒开颅手术是治疗脑功能区肿瘤的一种创新方法。清醒开颅术（AC）有多种麻醉技术，包括睡-醒-睡技术、麻醉监测管理，以及最近引入的醒-醒-醒方法。我们描述了我们在清醒开颅术麻醉管理方面的首次经验，该经验是将这些技术与头皮神经阻滞以及丙泊酚/瑞芬太尼靶控输注相结合。一名28岁男性接受了清醒开颅术以切除脑胶质瘤。实施了头皮神经阻滞，并维持低镇静状态直至骨瓣移除。在脑胶质瘤切除过程中，患者维持清醒状态且无任何并发症。一旦肿瘤切除完成，加深麻醉深度并插入喉罩气道。良好的心理准备、合理选择麻醉技术和药物，以及团队持续沟通是我们这位患者取得成功结果的一些关键挑战。
