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Patient-reported intraoperative experiences during awake craniotomy for brain tumors: a scoping review

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Abstract

Awake craniotomy (AC) is a neurosurgical procedure that may be used to excise tumors located in eloquent areas of the brain. The techniques and outcomes of AC have been extensively described, but data on patient-reported experiences are not as well known. To determine these, we performed a scoping review of patient-reported intraoperative experiences during awake craniotomy for brain tumor resection. A total of 21 articles describing 534 patients were included in the review. Majority of the studies were performed on adult patients and utilized questionnaires and interviews. Some used additional qualitative methodology such as grounded theory and phenomenology. Most of the evaluation was performed within the first 2 weeks post-operatively. Recollection of the procedure ranged from 0 to 100%, and most memories dealt with the cranial fixation device application, cranial drilling, and intraoperative mapping. All patients reported some degree of pain and discomfort, mainly due to the cranial fixation device and uncomfortable operative position. Most patients were satisfied with their AC experience. They felt that participating in AC gave them a sense of control over their disease and thought that trust in the treatment team and adequate pre-operative preparation were very important. Patients who underwent AC for brain tumor resection had both positive and negative experiences intraoperatively, but overall, majority had a positive perception of and high levels of satisfaction with AC. Successful AC depends not only on a well-conducted intraoperative course, but also on adequate pre-operative information and patient preparation.

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Taft Avenue, 1000, Ermita, Manila, Philippines

    Kathleen Joy O. Khu & Juan Silvestre G. Pascual

  2. Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

    Katrina Hannah D. Ignacio

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  1. Kathleen Joy O. Khu
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  2. Juan Silvestre G. Pascual
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  3. Katrina Hannah D. Ignacio
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Contributions

Kathleen Joy O. Khu: conceptualization, data curation, formal analysis, interpretation of data, writing—original draft, writing—review and editing.

Juan Silvestre G. Pascual: conceptualization, data curation, formal analysis, interpretation of data, writing—original draft, writing—review and editing.

Katrina Hannah D. Ignacio: conceptualization, data curation, formal analysis, interpretation of data, writing—original draft, writing—review and editing.

K. K., J. P., and K. I. conceptualized the study, performed the search, screened the articles for review, analyzed the content of the articles, wrote the original draft, revised the manuscript, and approved the final version for submission. J. P. and K. I. prepared Figs. 1 and 2.

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Correspondence to Kathleen Joy O. Khu.

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Kathleen Joy O. Khu and Juan Silvestre G. Pascual are joint primary authors.

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Khu, K.J.O., Pascual, J.S.G. & Ignacio, K.H.D. Patient-reported intraoperative experiences during awake craniotomy for brain tumors: a scoping review. Neurosurg Rev 45, 3093–3107 (2022). https://doi.org/10.1007/s10143-022-01833-0

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