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KMID : 0876320000020010037
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Cachon Medical Journal
2000 Volume.2 No. 1 p.37 ~ p.43
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Propofol Anesthesia for Awake Craniotomy in a Patient with Brain Tumor
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Park Hee-Kwon
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Abstract
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Purpose: Recently, functional cortical stimulation mapping is frequently used during craniotomy for the surgery of brain tumors within or close to the central motor or language areas. So we used propofol that provides excellent sedation and rapid recovery of mentality during awake craniotomy and evaluated the safety and efficacy of the anesthetic management.
Materials and Methods: The subjects were adult patients who would undergo awake craniotomy. After administering fentanyl 50 pg intravenously, local anesthetic infiltration was done to skin incision site with 1.5% mepivacaine containing 1:200,000 epinephrine. Anesthesia was induced by administering propofol 2 mg/kg and then maintained at the rate of 4-6 mg/kg/hr except during the awake period. Invasive arterial blood pressure, end-tidal CO2 and SpO2 were monitored throughout the operation and arterial blood gas analysis was done intermittently.
Results: During total infusion time (247.3 ± 116.6 min), propofol 21.6±8.5 mg/kg were administered. Hypercapnea (EtCO2 > 40 mmHg) were noticed in five patients, somnolence during mapping in three patients, brain swelling in one patient, decrease in respiratory rate to 8/min in one patient. Seizure during electrocorticogram, nausea or vomitting, and oxygen desaturation to 95% were not noticed. All the patients were cooperative and the above problem were solved by reducing propofol infusion rates.
Conslusion: Propofol infusion may be adequate method of anesthetic management for awake craniotomy.
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KEYWORD
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Awake craniotomy, Propofol
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