Abstract
The perioperative records of 354 consecutive patients undergoing craniotomy for surgical treatment of intractable epilepsy performed with conscious-sedation analgesia were reviewed retrospectively. There was no perioperative morbidity or mortality identified which could be attributed to the anaesthetic technique. The technique was not suitable for seven patients, in whom general anaesthesia was induced. The most frequent intraoperative problems were convulsions (16 per cent) and nausea and vomiting (eight per cent). Less frequent problems included excessive sedation (three per cent), “tight brain” (1.4 per cent) and local anaesthetic toxicity (two per cent). This study confirms that conscious-sedation analgesia provides suitable conditions for craniotomies when brain mapping is required.
Résumé
Nous avons revisé les dossiers de 354 patients ayant subi une craniotomie pour exérese de tissue épileptogenique. Ľanesthésie employée est une technique de sedation et ďanalgésie. Une étudie rétrospective a été entreprise pour identifier les complications anesthésiques. Il n’y a pas eu de mortalité ou de morbidité secondaire à la technique ďanesthêsie. Sept patients n’ont pas toléré ľintervention et ľinduction ďanesthêsie genérale à été nécessaire chez ces patients. Les problèmes per-opératoires les plus fréquents ont été les convulsions (16 pour cent), les nausées et les vomissements (huit pour cent). Moins fréquemment, sont survenus de la s’dation excessive (trois pour cent), de ľengorgement du cerveau (un pour cent), et des réactions toxiques à ľanesthésique local (un pour cent). Le monitorage de la pression ďoxygène transcutanée chez 11 patients sans complications per-opératoires n’ à révélé aucun hypoxie durant les interventions.
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Archer, D.P., McKenna, J.M.A., Morin, L. et al. Conscious-sedation analgesia during craniotomy for intractable epilepsy: a review of 354 consecutive cases. Can J Anaesth 35, 338–344 (1988). https://doi.org/10.1007/BF03010852
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DOI: https://doi.org/10.1007/BF03010852