PP37. PATIENT EXPERIENCE AND SATISFACTION WITH DEXMEDETOMIDINE IN AWAKE CRANIOTOMY FOR BRAIN TUMOURS

Abstract

INTRODUCTION: Gross total excision of high and low grade gliomas has been proven beneficial both by prolonging progress free survival and overall survival. In this context awake craniotomies for tumour resections as close as possible to eloquent brain have become popular. Patient experience has improved dramatically with the advent of the electromagnetic navigation which does not require rigid pin fixation of the head and allows conscious sedation throughout the procedure (AAA). Similarly new sedative medications like Dexmedetomidine have become available aiming to achieve the same level of sedation with less respiratory depression. METHODS: In this survey we used Dexmedetomidine intravenously to achieve conscious sedation in 40 consecutive patients who underwent awake craniotomy for an eloquently located brain tumour. After the patients recovered from the operation and were discharged, they were asked to complete a questionnaire that explored the way they experienced the awake craniotomy before, during and after the procedure. Dexmedetomidine use for awake craniotomies is standard practice in North America, but in this work we present the first UK experience of a series of patients. RESULTS: 32/40 responses received. Amongst these 19 patients remember being comfortable during the operation, 6 patients felt some discomfort, and 7 patients were not able to remember and comment on their experience during the operation. From the anaesthetic point of view none of these patients required any intraoperative airway intervention. The satisfaction results are comparable to a previous survey carried out in our unit in 2011 which looked at the level of satisfaction with Propofol and Remifentanil. CONCLUSIONS: The outcome of our survey looking at the use of dexmedetomidine +/- remifentanil matches the previous study in our institution using remifentanil+/-propofol and appears to be as equally as tolerated by patients. The use of dexmedetomidine has the added benefit of little or no respiratory depression. Larger studies are required to explore the true potential of dexmedetomidine further.