Korean J Anesthesiol.  2010 Dec;59(Suppl):S179-S182. 10.4097/kjae.2010.59.S.S179.

Anesthetic management with scalp nerve block and propofol/remifentanil infusion during awake craniotomy in an adolescent patient: A case report

• Sung B
• Kim HS
• Park JW
• Byon HJ
• Kim JT
• Kim CS

• KMID: 2237382
• DOI: http://doi.org/10.4097/kjae.2010.59.S.S179

Abstract

Despite of various neurophysiologic monitoring methods under general anesthesia, functional mapping at awake state during brain surgery is helpful for conservation of speech and motor function. But, awake craniotomy in children or adolescents is worrisome considering their emotional friabilities. We present our experience on anesthetic management for awake craniotomy in an adolescent patient. The patient was 16 years old male who would undergo awake craniotomy for removal of brain tumor. Scalp nerve block was done with local anesthetics and we infused propofol and remifentanil with target controlled infusion. The patient endured well and was cooperative before scalp suture, but when surgeon sutured scalp, he complained of pain and was suddenly agitated. We decided change to general anesthesia. Neurosurgeon did full neurologic examinations and there was no neurologic deficit except facial palsy of right side. Facial palsy had improved with time.

Keyword

Adolescent; Awake craniotomy; Nerve block

MeSH Terms

Adolescent
Anesthesia, General
Anesthetics, Local
Brain
Brain Neoplasms
Child
Craniotomy
Dihydroergotamine
Facial Paralysis
Humans
Male
Nerve Block
Neurologic Examination
Neurologic Manifestations
Piperidines
Propofol
Scalp
Sutures
Anesthetics, Local
Dihydroergotamine
Piperidines
Propofol