Anesthesia in Awake Craniotomy: Advantages of Dexmedetomidine Infusion over Conventional Methods

Abstract

Background/objectives: Dexmedetomidine, an α 2 agonist used as infusion with scalp block, is a good adjuvant with analgesic, anxiolytic, and sedative effect with minimal effects on hemodynamic changes and respiration depression. In this study, we report the efficacy of dexmeditomidine for awake craniotomy. Materials and methods: Three American Society of Anesthesiologists grade 2 patients were posted for tumor resection under awake craniotomy. Scalp block was given with local anesthetic and dexmedetomidine bolus dose of 1 μg/kg/hr followed by 0.2 to 0.4 μg/kg/hr. The patient's speech was monitored by oral questionnaire, motor strength by hand squeezing, and sedation by modified Ramsay Hunt Score. Results: Bolus dose of 1 μg/kg over 20 minutes infusion of 0.2 to 0.4 μg/kg/hr is a good adjuvant with scalp block with minimal hemodynamic changes. Conclusion: Dexmedetomidine is a useful adjuvant during awake craniotomy for tumor resection. It has minimal effect on hemodynamics and respiratory system. It can be used in procedures where cooperation of the patient is required intraoperatively.