• K Prabhakaran, Cvr Mohan, P C Tripathy, P K Sahoo, and K I Mathai.
• Classified Specialist (Anaesthesia and Neuroanaesthesia), 166 Military Hospital, C/o 56 APO.
• Med J Armed Forces India. 2008 Oct 1; 64 (4): 308-10.

BackgroundCraniotomy and excision of tumours can produce neurological deficits if the tumour is located close to eloquent areas of the brain. One technique of overcoming this problem is to keep the patient 'awake' during surgery.MethodsEight patients with intra cranial space occupying lesions (ICSOL) were operated 'awake', using a combination of skull block with sedation and analgesia. A mixture of 0.125% bupivacaine and 0.5% lignocaine was used for various nerve and field blocks. Midazolam, fentanyl and propofol in titrated doses were used to achieve conscious sedation.ResultThe procedure was successful in all the patients. They tolerated the procedure well and were able to follow the commands intraoperatively as desired. There were no significant complications.ConclusionAwake craniotomy with skull blocks with sedation and analgesia is a well established procedure. It requires a good rapport between surgeon, anaesthesiologist and the patient.

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