The usefulness of the awake-awake-awake technique
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We agree that an awake patient is the best candidate for intraoperative neurological testing, and it is obvious that the less the patient is mentally compromised by sedatives, the better the test results will be. Thus, in a recent publication we could demonstrate that patients show unimpaired alertness with our procedure, whereas higher cognitive functions were compromised for at least an hour in other patients with intermittent anesthesia or sedation with propofol .
We fully agree that during the purely surgical phases the patient should not follow this in the sense of focusing on the surgical procedure. Duffau here suggests the use of sedation in accordance with the common asleep-awake-asleep technique. As the sedatives and anesthetics in question are also called “hypnotics”, it is justified to ask if only a pharmacological...
KeywordsAstrocytoma Delay Testing High Cognitive Function Emotional Feeling Neurological Testing
Conflicts of interest
- 1.Beez T, Boge K, Wager M, Whittle I, Fontaine D, Spena G, Braun S, Szelényi A, Bello L, Duffau H, Sabel M, European Low Grade Glioma Network (2013) Tolerance of awake surgery for glioma: a prospective European low grade glioma network multicenter study. Acta Neurochir (Wien) 155(7):1301–1308CrossRefGoogle Scholar
- 4.Faymonville M-E, Bejenke CJ, Hansen E (2010) Hypnotic techniques. In: Cyna A, Andrew MI, Tan SGM, Smith AF (eds) Handbook of communication in anaesthesia and critical care, chap. 20. Oxford University Press, Oxford, pp 249–261Google Scholar
- 6.Ott C, Kerscher C, Luerding R, Doenitz C, Hoehne J, Zech N, Seemann M, Schlaier J, Brawanski A (2014) The impact of sedation on brain mapping: a prospective, interdisciplinary clinical trial. Neurosurgery DOI: 10.1227/NEU.0000000000000359