Dexmedetomidine for awake craniotomy without laryngeal mask

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This paper reports the use of dexmedetomidine in three epileptic patients with cavernous angiomas that underwent awake surgery in order to map their speech areas. Loading dose of dexmedetomidine varied from 1 microg/Kg/h to 3 microg/Kg/h over 20 minutes and maintenance dose from 0.4 microg/Kg/h to 0.8 microg/Kg/h. There was no occurrence of hemodynamic instability, convulsions or respiratory depression. Patients tolerated well the procedure. Dexmedetomidine was useful for awake craniotomy as it decreased patients level of consciousness but did not produce agitation. Laryngeal mask was not necessary to keep air ventilation.