• Masayuki Okada, Kousuke Takata, and Kaneyuki Kawamae.
• Department of Anesthesiology, Yamagata University School of Medicine, Yamagata.
• Masui. 2010 Jan 1;59(1):75-81.

BackgroundRemifentanil has strong analgesic fore tried to use remifentanil for anesthetic management of awake craniotomy (AC) and assessed its efficacy.MethodsThe patients underwent AC with general anesthesia by propofol (P group, n = 17), or by propofol and remifentanil (PR group, n = 13), and were analyzed retrospectively. We investigated (1) systolic blood pressure (SBP) and heart rate (HR) until first 60 minutes after starting the operation, (2) the time from cessation of anesthetics to awakening for brain mapping, and (3) anesthetic complications.ResultsThe patients in PR group were infused remifentanil by 0.22 +/- 0.06 microg x kg(-1) x min(-1) and all needed controlled ventilation with laryngeal mask airway. The increase of HR after starting the operation was lower in PR group (P < 0.01). The time to awakening was not significant by defference between them. In anesthetic complications, the incidence of movement during the general anesthesia was more frequent in P group (P < 0.01). Other complications occurred similarly and were controllable.ConclusionsRemifentanil is effective for anesthetic management of AC. However, respiratory management is necessary.

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