Combination of Continuous Dexmedetomidine Infusion with Titrated Ultra-Low-Dose Propofol-Fentanyl for an Awake Craniotomy : Case report

• Main Authors: Samaresh Das, Ali Al-Mashani, Neelam Suri, Neeraj Salhotra, Nilay Chatterjee
• Format: Article
• Language: English
• Published: Sultan Qaboos University 2016-08-01
• Series: Sultan Qaboos University Medical Journal
• Subjects: anesthesia; craniotomy; dexmedetomidine; propofol; fentanyl; case report; oman.
• Online Access: https://journals.squ.edu.om/index.php/squmj/article/view/2164

An awake craniotomy is a continuously evolving technique used for the resection of brain tumours from the eloquent cortex. We report a 29-year-old male patient who presented to the Khoula Hospital, Muscat, Oman, in 2016 with a two month history of headaches and convulsions due to a space-occupying brain lesion in close proximity with the left motor cortex. An awake craniotomy was conducted using a scalp block, continuous dexmedetomidine infusion and a titrated ultra-low-dose of propofol-fentanyl. The patient remained comfortable throughout the procedure and the intraoperative neuropsychological tests, brain mapping and tumour resection were successful. This case report suggests that dexmedetomidine in combination with titrated ultra-low-dose propofolfentanyl are effective options during an awake craniotomy, ensuring optimum sedation, minimal disinhibition and a rapid recovery. To the best of the authors’ knowledge, this is the first awake craniotomy conducted successfully in Oman.