2019 Volume 39 Issue 2 Pages 156-163
Awake craniotomy is primarily performed for the resection of a brain tumor encompassing the eloquent cortex, including the language and motor areas. Awake craniotomy facilitates live intraoperative speech and motor monitoring with the primary objective of maximum tumor resection and the preservation or enhancement of complex brain function. Currently, the asleep-awake-asleep method using general anesthesia before and after live brain function monitoring and the awake-awake-awake method using conscious sedation without invasive airway devices through the operation comprise the main anesthetic techniques for awake craniotomy. Both anesthetic techniques require an understanding of monitored anesthesia care（MAC）, a concept defined as “a specific anesthesia service for a diagnostic or therapeutic procedure that may include varying levels of sedation, analgesia and anxiolysis as necessary”. The provider of MAC must be prepared and qualified to convert to general anesthesia when necessary.
In this article, we provide an outline of MAC in awake craniotomy and discuss its advantages and precautions in its implementation.
