PT  - JOURNAL ARTICLE
AU  - Caparlar, Ceyda Ozhan
AU  - Sipahioğlu, Fatma Özkan
AU  - İşlek, Reyhan
AU  - Kalan, Mehmet
AU  - Ozay, Rafet
TI  - #34467 Awake craniotomy with sleep-awake-awake tecnique
AID  - 10.1136/rapm-2023-ESRA.569
DP  - 2023 Sep 01
TA  - Regional Anesthesia & Pain Medicine
PG  - A298--A298
VI  - 48
IP  - Suppl 1
4099  - http://rapm.bmj.com/content/48/Suppl_1/A298.1.short
4100  - http://rapm.bmj.com/content/48/Suppl_1/A298.1.full
SO  - Reg Anesth Pain Med2023 Sep 01; 48
AB  - Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA PrizesBackground and Aims The goal of case report is the management of awake craniotomy with sleep-awake-awake tecnique. An awake craniotomy is a surgical procedure in which patient is deliberately kept awake during whole surgical process or a portion of surgery.Methods The patient was a 49-year-old male; MRI revealed a 42x38 mm glial tumor in the temporal region, close to Broca area, in the structures of the neurosurgery clinic with a complaint of headache. A craniotomy with scalp block was planned for the patient. Consent was obtained after preoperative information was given. Standard anesthesia monitoring(ASA) was performed on the patient. We planned the sleep-awake-awake technique in awake craniotomy. In induction, 2.5mg/kg of propofol, 1.5mcg/kg of fentanyl and 1mg/kg of lidocaine were administered. A supraglottic airway device, I-gel, is inserted. Then, scalp block was performed with 0.5% bupivacaine. Neurosurgeon applied Mayfield pine. As neurosurgeon approached where the tumor was located, the stage of awakening the birth was started. Before these steps, a loading dose of dexmedetomidine 1mcg/kg was given as a 15-minute infusion in 100cc fluid, and 0.2mcg/kg/hour was switched to maintenance. Remifentanil and sevoflurane are reduced and turned off after 15minutes. The patient whose spontaneous breathing started was awakened, and i-gel laryngeal mask was removed. The patient was talked to every 3-5 minutes until the tumor area was reached and controlled by starting the engine. The patient would talk long enough to answer the questions.Abstract #34467 Figure 1 Patient MRIResults Awake craniotomy is multidisciplinary teamwork, and the anesthesiologist should know for various purposes, scalp blockage, and forward referral management.