Year : 2008  |  Volume : 2  |  Issue : 2  |  Page : 52-56

Patient satisfaction following awake craniotomy

1 Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London Health Sciences Centre, 339 Windermere Road, London N6A 5A5. Canada
2 Department of Clinical Neurological Sciences (Division of Neurosurgery), University of Western Ontario, London Health Sciences Centre, 339 Windermere Road, London, N6A 5A5., Canada

Correspondence Address:
N Khalifah
Department of Anesthesia, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, P.O Box 3354, Saudi Arabia.

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Source of Support: None, Conflict of Interest: None

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Background: Awake craniotomy using local anaesthesia and monitored conscious sedation is widely used for the excision of intracranial tumors or vascular abnormalities or for the management of refractory seizures. Propofol combined with remifentanil represents a popular technique for the provision of conscious sedation during these procedures. This study evaluated patient satisfaction following awake craniotomy performed under propofol-remifentanil sedation. The study also assessed the incidence of intraoperative and postoperative complications associated with this technique. Method: This prospective study evaluated the satisfaction of 25 adult patients undergoing awake craniotomy under propofol-remifentanil sedation. Evaluation involved interviewing patients at 1 hour, 24 hours, and 6 weeks postoperatively. Postoperative recall of pain, anxiety, and discomfort were assessed at 1 hour, 24 hours, and 6 weeks postoperatively. Surgeon and anesthesiologist satisfaction was also evaluated at the end of each procedure. Results: At 1 hour postoperative assessment, twenty-four patients (96%) were satisfied with the anesthetic technique. Patient satisfaction scores were similar at 1 hour, 24 hours and 6 weeks postoperatively. Twenty­one of the twenty-four patients (84%) stated that they would choose the same anesthetic technique if they were to undergo the same procedure again. Surgeons and anesthesiologists were satisfied in twenty-three cases (92%). Conclusion: This study confirms that monitored conscious sedation with propofol-remifentanil is a useful alternative technique for awake craniotomy with a high patient, surgeon and anesthetist satisfaction.

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