• Karsten H Wrede, Lennart H Stieglitz, Antje Fiferna, Matthias Karst, Venelin M Gerganov, Madjid Samii, Hans-Henning von Gösseln, and Wolf O Lüdemann.
• University Hospital Essen, Department of Neurosurgery, Hufelandstrasse 55, 45147 Essen, Germany. karsten@dr-wrede.com
• Clin Neurol Neurosurg. 2011 Dec 1;113(10):880-4.

ObjectivesThe aim of this study was to objectively assess the patients' acceptance for awake craniotomy in a group of neurosurgical patients, who underwent this procedure for removal of lesions in or close to eloquent brain areas.Patients And MethodsPatients acceptance for awake craniotomy under local anesthesia and conscious sedation was assessed by a formal questionnaire (PPP33), initially developed for general surgery patients. The results are compared to a group of patients who had brain surgery under general anesthesia and to previously published data.ResultsThe awake craniotomy (AC) group consisted of 37 male and 9 female patients (48 craniotomies) with age ranging from 18 to 71 years. The general anesthesia (GA) group consisted of 26 male and 15 female patients (43 craniotomies) with age ranging from 26 to 83 years. All patients in the study were included in the questionnaire analysis. In comparison to GA the overall PPP33 score for AC was higher (p=0.07), suggesting better overall acceptance for AC. The subscale scores for AC were also significantly better compared to GA for the two subscales "postoperative pain" (p=0.02) and "physical disorders" (p=0.01) and equal for the other 6 subscales. The results of the overall mean score and the scores for the subscales of the PPP33 questionnaire verify good patients' acceptance for AC.ConclusionPrevious studies have shown good patients' acceptance for awake craniotomy, but only a few times using formal approaches. By utilizing a formal questionnaire we could verify good patient acceptance for awake craniotomy for the treatment of brain tumors in or close to eloquent areas. This is a novel approach that substantiates previously published experiences.Copyright © 2011 Elsevier B.V. All rights reserved.

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