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Author Gadhinglajkar, S. ♦ Sreedhar, Rupa ♦ Abraham, M.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Neurology India
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Surgery & related medical specialties
Subject Domain (in MeSH) Nervous System Diseases ♦ Diseases ♦ Therapeutics ♦ Surgical Procedures, Operative ♦ Investigative Techniques ♦ Equipment and Supplies ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Musculoskeletal and Neural Physiological Phenomena ♦ Biological Sciences
Subject Keyword Anaesthesia
Abstract Asleep-awake-asleep technique of anesthesia is used during awake craniotomy with or without securing airway. We assessed this technique using laryngeal mask airway (LMA) in two patients. Patients underwent awake craniotomy for epilepsy surgery and the removal of a frontotemporal glioma. After anesthesia induction, airway was secured using LMA. Anesthesia was maintained using oxygen, nitrous oxide and sevoflurane, supplemented with an infusion of propofol and remifentanil. Twenty minutes before corticography, anesthesia was discontinued and LMA removed. Both patients were awake and cooperative during the neurological assessment and surgery on eloquent areas. The LMA was reinserted before the closure of the dura and remained in place until the end of surgery. Both patients had no recall of events under anesthesia, although experienced mild pain and discomfort during awake phase of surgery. Both expressed complete satisfaction over the anesthetic management. Asleep-awake-asleep technique using LMA offers airway protection. The painful aspect of surgery can be performed under anesthesia, hence minimizing the duration of stress and pain. Patients remained awake and cooperative throughout the time of neurological testing.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Journal Neurology India
Volume Number 56
Issue Number 1
Page Count 59
Starting Page 7
Ending Page 65