Anestesia para la craneotomía en el paciente consciente / Anesthesia for craniotomy in the conscious patient

La craneotomía en el paciente consciente (CPC) permite valorar los cambios neurológicos durante la obtención de mapas neurológicos en la cirugía de la epilepsia, la localización de los electrodos durante la cirugía de estimulación cerebral profunda y la extirpación tumoral en áreas elocuentes del cerebro. La CPC consciente es útil para realizar cirugía radical, minimizando el daño en las zonas funcionales del cerebro. El anestesiólogo debe asegurar un adecuado bienestar al paciente, una óptima analgesia y garantizar su colaboración. Se debe realizar una adecuada selección conjunta de los posibles candidatos con todos los profesionales implicados en el caso. El conocimiento de las distintas fases de esta forma de craneotomía, la coordinación y comunicación entre los especialistas, el dominio de la farmacología y de las técnicas anestésicas específicas, junto con la capacidad de comunicación psicoemocional con el paciente, son los determinantes del éxito del procedimiento, que debe someterse, además, a la cultura de seguridad. El objetivo de esta revisión es describir el tratamiento anestésico integral, las consideraciones neurofisiológicas y las complicaciones intraoperatorias de la CPC(AU)

Craniotomy in the conscious patient (CPC) enables the neurological changes to be assessed during the mapping in epilepsy surgery, the location of the electrodes during deep brain stimulation surgery, and tumor resection in eloquent areas of the brain. CPC is a useful technique for radical surgery in order to minimize the damage to the functional areas of the brain. The anesthesiologist must ensure, adequate patient comfort, analgesia and ensure optimal collaboration. The appropriate selection of potential candidates for CPC should be made jointly with all professionals involved in the case. Knowledge of the different phases of CPC, coordination and communication among specialists, the right management of the pharmacology, and anesthetic techniques specific to CPC, along with the ability of psycho-emotional communication with the patient, determine the success of the procedure to be performed in the culture of patient safety. The aim of this review was to describe the anesthetic management, comprehensive considerations, and intraoperative neurophysiological tests for CPC(AU)

[Anesthesia for craniotomy in the conscious patient]. / Anestesia para la craneotomía en el paciente consciente.

Craniotomy in the conscious patient (CPC) enables the neurological changes to be assessed during the mapping in epilepsy surgery, the location of the electrodes during deep brain stimulation surgery, and tumor resection in eloquent areas of the brain. CPC is a useful technique for radical surgery in order to minimize the damage to the functional areas of the brain. The anesthesiologist must ensure, adequate patient comfort, analgesia and ensure optimal collaboration. The appropriate selection of potential candidates for CPC should be made jointly with all professionals involved in the case. Knowledge of the different phases of CPC, coordination and communication among specialists, the right management of the pharmacology, and anesthetic techniques specific to CPC, along with the ability of psycho-emotional communication with the patient, determine the success of the procedure to be performed in the culture of patient safety. The aim of this review was to describe the anesthetic management, comprehensive considerations, and intraoperative neurophysiological tests for CPC.