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清醒开颅术在脑肿瘤中的应用——技术系统化与现状。

Awake craniotomy in brain tumors - Technique systematization and the state of the art.

机构信息

- Irmandade da Santa Casa de Misericórdia de São Paulo, Anestesiologia - ISCMSP, SP, Brasil.

- Hospital Sírio Libanês - São Paulo, SP, Brasil.

出版信息

Rev Col Bras Cir. 2021 May 7;48:e20202722. doi: 10.1590/0100-6991e-20202722. eCollection 2021.

Abstract

The anesthesia for awake craniotomy (AC) is a consecrated anesthetic technique that has been perfected over the years. Initially used to map epileptic foci, it later became the standard technique for the removal of glial neoplasms in eloquent brain areas. We present an AC anesthesia technique consisting of three primordial times, called awake-asleep-awake, and their respective particularities, as well as delve into the anesthetic medications used. Its use in patients with low and high-grade gliomas was favorable for the resection of tumors within the functional boundaries of patients, with shorter hospital stay and lower direct costs. The present study aims to systematize the technique based on the experience of the largest philanthropic hospital in Latin America and discusses the most relevant aspects that have consolidated this technique as the most appropriate in the surgery of gliomas in eloquent areas.

摘要

清醒开颅术的麻醉(AC)是一种经过多年完善的专业麻醉技术。最初用于定位癫痫灶,后来成为在功能区切除神经胶质瘤的标准技术。我们介绍了一种清醒-睡眠-清醒的 AC 麻醉技术,分为三个阶段,每个阶段都有其特点,并深入探讨了所用的麻醉药物。该技术在低级别和高级别脑胶质瘤患者中的应用有利于在患者功能边界内切除肿瘤,住院时间更短,直接成本更低。本研究旨在根据拉丁美洲最大的慈善医院的经验对该技术进行系统整理,并讨论巩固该技术作为功能区脑胶质瘤手术中最合适技术的最相关方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f883/10683424/d3ba15c068c6/rcbc-48-e20202722-g001.jpg

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