Recent Trends in Anesthetic Management for Craniotomy of Supratentorial Tumors

Abstract

SUMMARY B rain tumors represent a group of neoplasms arising from brain tissue, each with their own unique biology, prognosis, and treatment. Included in this group are neoplasms not arising from brain parenchyma, which encompass meningiomas, lymphomas, and metastatic disease from other primary sources (often referred to as secondary brain tumors). Despite the diverse group of neoplasms represented, most intracranial tumors follow similar clinical presentations and diagnostic workup. Patients with supratentorial lesions in proximity to the eloquent cortex had better neurological outcome and maximal tumor removal with awake craniotomy (AC) than surgery under general anesthesia (GA). AC provides a feasible alternative to craniotomy under GA. Scalp block has a steep learning curve and its practice will undoubtedly help the anesthesiologist in the perioperative management of patients undergoing craniotomy. The application of awake craniotomy has been continually evolving. The success of each different anesthetic technique depends on proper preoperative preparation, proper anesthetic technique, proper choice of anesthetic agents and immediate management of complications.