XXXX and neurocognitive testing in awake craniotomy.

@entity1 @entity51 @entity1576 @entity1875 @entity6948
@entity1 are selected for awake craniotomy when the planned procedure involves eloquent areas of the brain, necessitating an awake, cooperative @entity1 capable of undergoing neurocognitive testing. Different anesthetic combinations, including neurolept, @entity1875 with or without opioid infusions, and asleep-awake-asleep techniques, have been reported for awake craniotomy. In all these techniques, @entity1576 has been reported as a complication. In this case series @entity6948 , the highly selective alpha-2 adrenoreceptor agonist, was selected for its lack of @entity1576 as well as its sedative and analgesic properties. The charts of 10 consecutive @entity1 who underwent awake craniotomy with @entity6948 infusion were reviewed. Five of the @entity1 underwent "asleep-awake" technique with a laryngeal mask airway and volatile agent. Five @entity1 received moderate to conscious sedation. All @entity1 received a @entity6948 load of 0.5 to 1.0 microg/kg over 20 minutes followed by an infusion at rates of 0.01 to 1.0 microg/kg per hour. Four @entity1 had extensive sensory and motor testing, and six underwent neurocognitive testing, including naming, reading, counting, and verbal fluency. There were no permanent @entity51 , except one @entity1 who had an exacerbation of preoperative language difficulties. @entity6948 appears to be a useful sedative for awake craniotomy when sophisticated neurologic testing is required.
