Combination of continuous dexmedetomidine infusion with titrated ultra-low-dose propofol-fentanyl for an awake craniotomy : case report

Abstract EN

An awake craniotomy is a continuously evolving technique used for the resection of brain tumours from the eloquent cortex.

We report a 29-year-old male patient who presented to the Khoula Hospital, Muscat, Oman, in 2016 with a two month history of headaches and convulsions due to a space-occupying brain lesion in close proximity with the left motor cortex.

An awake craniotomy was conducted using a scalp block, continuous dexmedetomidine infusion and a titrated ultra-low-dose of propofol-fentanyl.

The patient remained comfortable throughout the procedure and the intraoperative neuropsychological tests, brain mapping and tumour resection were successful.

This case report suggests that dexmedetomidine in combination with titrated ultra-low-dose propofolfentanyl are effective options during an awake craniotomy, ensuring optimum sedation, minimal disinhibition and a rapid recovery.

To the best of the authors’ knowledge, this is the first awake craniotomy conducted successfully in Oman