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The experience of patients undergoing awake craniotomy for intracranial masses: Expectations, recall, satisfaction and functional outcome

Manchella, Sankar; Khurana, Gautam (Vini); Duke, David; Brussel, Thomas; French, James; Zuccherelli, Lisa

Description

Introduction. Awake craniotomy is a well-established neurosurgical technique for lesions involving eloquent cortex, however, there is little information regarding patients' subjective experience with this type of surgery. Here we explore the expectations, recall, satisfaction and functional outcome of patients undergoing awake craniotomy. Methods. Three semi-structured interviews using closed- and open-ended questions were conducted with each of 26 consecutive patients (17 males, 9 females;...[Show more]

dc.contributor.authorManchella, Sankar
dc.contributor.authorKhurana, Gautam (Vini)
dc.contributor.authorDuke, David
dc.contributor.authorBrussel, Thomas
dc.contributor.authorFrench, James
dc.contributor.authorZuccherelli, Lisa
dc.date.accessioned2015-12-10T23:33:26Z
dc.identifier.issn0268-8697
dc.identifier.urihttp://hdl.handle.net/1885/69322
dc.description.abstractIntroduction. Awake craniotomy is a well-established neurosurgical technique for lesions involving eloquent cortex, however, there is little information regarding patients' subjective experience with this type of surgery. Here we explore the expectations, recall, satisfaction and functional outcome of patients undergoing awake craniotomy. Methods. Three semi-structured interviews using closed- and open-ended questions were conducted with each of 26 consecutive patients (17 males, 9 females; aged 16-78 years) who underwent their first awake craniotomy between 2007 and 2009. Seven patients were interviewed retrospectively, 19 prospectively. Clinical data are included. Results. The following themes emerged from this study: (1) most patients demonstrated a good understanding of the rationale behind awake craniotomy; (2) patients felt the asleep-awake-asleep anaesthetic protocol used in this series was appropriate; (3) patients' confidence and preparedness for surgery was high, attributed to preparation by the surgical team. Seven of 26 (27%) patients had no recollection of being awake. Most patients had a positive anaesthetic and surgical experience, while a minority of patients reported experiencing more than slight pain (2/26; 8%) and discomfort (3/26; 12%), fear (4/26; 15%) or claustrophobia (1/26; 4%) intra-operatively. At follow-up (6 weeks post-operatively), most patients were functionally unimpaired; there was only one permanent neurological complication of surgery. We found that 24/26 (92%) patients were satisfied with their experience; one patient had no opinion and another one was unsatisfied. Five of 26 (19%) patients still reported more than slight discomfort, and 3/26 (12%) reported more than slight pain attributable to the surgery. A summary of the English peer-reviewed literature on the patient experience of awake craniotomy is also incorporated. Conclusions. This study confirms that awake craniotomy using the 'asleep-awake-asleep' anaesthetic protocol is a generally safe and well-tolerated procedure associated overall with satisfactory patients' experiences and neurological outcomes.
dc.publisherInforma Healthcare
dc.sourceBritish Journal of Neurosurgery
dc.subjectKeywords: clonidine; dexamethasone; propofol; remifentanil; adolescent; adult; aged; arousal; article; awake craniotomy; brain disease; claustrophobia; clinical article; clinical protocol; comprehension; craniotomy; expectation; female; follow up; functional status Awake craniotomy; brain tumour; cerebrovascular disease; outcome; patient experience
dc.titleThe experience of patients undergoing awake craniotomy for intracranial masses: Expectations, recall, satisfaction and functional outcome
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume25
dc.date.issued2011
local.identifier.absfor110323 - Surgery
local.identifier.absfor110504 - Oral and Maxillofacial Surgery
local.identifier.ariespublicationf2965xPUB1990
local.type.statusPublished Version
local.contributor.affiliationManchella, Sankar, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationKhurana, Gautam (Vini), College of Medicine, Biology and Environment, ANU
local.contributor.affiliationDuke, David, The Canberra Hospital
local.contributor.affiliationBrussel, Thomas, The Canberra Hospital
local.contributor.affiliationFrench, James, The Canberra Hospital
local.contributor.affiliationZuccherelli, Lisa, The Canberra Hospital
local.description.embargo2037-12-31
local.bibliographicCitation.issue3
local.bibliographicCitation.startpage391
local.bibliographicCitation.lastpage400
local.identifier.doi10.3109/02688697.2011.568640
dc.date.updated2016-02-24T08:20:57Z
local.identifier.scopusID2-s2.0-79957601619
CollectionsANU Research Publications

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