Preoperative Risk Assessment Before Elective Craniotomy: Are Aspirin, Arrhythmias, Deep Venous Thromboses, and Hyperglycemia Contraindications to Surgery?

Objective: Perioperative risk assessment and stratification before craniotomy is necessary to identify and optimize modifiable risk factors. Due to the high costs of diagnostic testing and concerns for delaying surgery, some have questioned whether and when surgery delays are warranted and supported by the current body of literature. The objective of this scoping review was to evaluate the available evidence on the prognostic value of preoperative risk assessment before anesthesia for elective craniotomy.

Preoperative Versus Postoperative Scalp Block Combined With Incision Line Infiltration for Pain Control After Supratentorial Craniotomy.

Objective: Postoperative pain after craniotomy is a significant clinical problem that is sometimes underestimated, although moderate or severe pain in early postoperative period complicates up to 60% of cases. The purpose of this prospective randomized multicenter trial was to determine the optimal timing for selective scalp block in patients undergoing general anesthesia for supratentorial craniotomy.

Materials And Methods: After ethics committee approval and informed consent, 56 adult patients were enrolled, and randomly assigned to receive a selective scalp block combined with incision line infiltration preoperatively or postoperatively.

A comprehensive analysis of patient satisfaction with anesthesia.

Background: Patient satisfaction with anesthesia after surgical treatment is a complex concept that includes not only the level of satisfaction with the anesthesia itself but also the presence of fears, worries, depression, evaluation of the anesthesiologists' work, as well as cognitive dysfunction as a possible negative consequence of anesthesia.

Objective: Conducting a comprehensive analysis of patients' satisfaction with anesthesia.

Methods: Questionnaire of patients' satisfaction with anesthesia (Sinbukhova E.

Xenon anesthesia for awake craniotomy: safety and efficacy.

Background: The asleep-awake-asleep (AAA) craniotomy is a technique that offers the opportunity of having a patient fully cooperative during the awake phase, and minimizes the possible discomfort, due to the asleep phase. The aim of this prospective observational study was to test the use of xenon in the first asleep phase of an AAA craniotomy, in patients undergoing craniotomy for brain tumor resection.

Methods: The data have been collected from 40 awake craniotomy procedures, performed in patients with cerebral tumor, treated with the AAA technique.

Anesthesia for awake craniotomy.

Purpose Of Review: The current review reports on current trends in the anesthetic management of awake craniotomy, including preoperative preparation, sedation schemes, pain management, and prevention of intraoperative complications.

Recent Findings: Both approaches for anesthesia for awake craniotomy, asleep-awake-asleep and monitored anesthesia care (MAC), have shown equal efficacy for performing intraoperative brain mapping. Choice of the appropriate scheme is currently based mainly on the preferences of the particular anesthesiologist.

'Scheduled' dosing of lornoxicam provides analgesia superior to that provided by 'on request' dosing following craniotomy.

Background And Objectives: The aim of this study was to compare the efficacy of 'scheduled' analgesia with analgesia 'on request in patients after craniotomy.

Patients And Methods: We performed a prospective randomized study comparing 'scheduled' analgesia with analgesia 'on request' on 126 patients aged 16-70 years undergoing craniotomy for a variety of reasons. Patients were randomized to one of two groups; group 1 (68 patients) received lornoxicam 'on request', and group 2 (58 patients) received 8 mg of lornoxicam preoperatively, immediately after intubation, then 8 mg again 6-8 h after the first injection and 8 mg repeated every 8 h for 48 h postoperatively.