ABSTRACT
This chapter describes the goals, investigations, premedication, intravenous access, monitors and induction of the awake craniotomy. It also describes the maintenance, positioning, intravenous fluids and postoperative analgesia of the awake craniotomy. The chapter discusses the hemogram, serum electrolytes, renal and liver function tests, coagulation parameters, electrocardiography (ECG), and chest X-ray (CXR). Echocardiography should be considered to detect any existing patent foramen ovale for patients scheduled for craniotomy in sitting position. Preoperative evaluation should include informing the patient about the nature of the procedure, in terms of duration and restriction of movement. A large-bore multiorifice central venous catheter placement should be considered with its tip above the superior vena caval–right atrium (RA) junction to attempt aspiration of air from the RA. Dexmedetomidine can be used within an infusion rate of 0.1–0.2 µg/kg/h without interfering with recordings and without suppressing the symptoms of the patient.
