Awake anesthesia for neurosurgery: case report
DOI:
https://doi.org/10.37497/JMRReview.v3i00.63Keywords:
Anesthesiology, Neurology, Neurosurgery, Anesthetic ProcedureAbstract
Background: Awake anesthesia (AWAKE) is an advanced technique used primarily in neurosurgeries involving critical functional areas of the brain, allowing the patient to remain conscious for real-time neurological monitoring. This approach allows the preservation of essential functions, such as speech and movement, during procedures such as tumor resection and epilepsy treatment. However, it presents challenges, such as the need to keep the patient calm and ensure effective pain control, in addition to requiring an experienced team to monitor vital functions and deal with possible intraoperative complications. Aim: To report a case of awake anesthesia for neurosurgery performed in our Service.
Method: This is a case report of a patient treated at the Hospital Universitário São Francisco na Providência de Deus – HUSF, located in the city of Bragança Paulista – SP, Brazil.
Case Report: This was a 42-year-old patient, with no comorbidities, who presented with a seizure, leading to investigation of a brain tumor, and Depakene was started to prevent further seizures. Assessed as low risk for obstructive sleep apnea, the patient underwent surgery to remove a tumor in the motor region of the brain under general anesthesia and intraoperative awareness. The technique was explained to the patient, highlighting the benefits and risks. During surgery, several monitoring and anesthetic support devices were used. The procedure was successful, with the patient responding adequately during awareness and being transferred to the ICU in good hemodynamic conditions.
Conclusion: General anesthesia with intraoperative awareness allowed safe removal of the tumor, preserving motor function and reducing the risk of permanent neurological deficits. The technique, although complex, proved to be effective for patients with tumors in critical regions. The success of the procedure highlighted the importance of careful coordination between anesthesia and surgery, advanced monitoring, and appropriate use of sedatives. In addition, the case highlighted the need for informed consent and adequate patient preparation to ensure the safety and success of the surgery.
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