# Anesthetic Management of Awake Craniotomy Versus Traditional Craniotomy at a Single Academic Center: A Retrospective Review

## TL;DR

This study compares anesthetic management in awake and traditional craniotomies, finding lower opioid use in awake procedures without affecting hospital stay.

## Contribution

The study introduces a new protocol for awake craniotomy and evaluates its anesthetic outcomes at a single academic center.

## Key findings

- Awake craniotomy patients had significantly reduced opioid requirements.
- There was no difference in hospital length of stay between the two groups.
- Anesthetic management in awake craniotomies was feasible and effective.

## Abstract

Awake craniotomies (AC) are an increasingly popular surgical technique used in medical institutions worldwide. This rise in adoption is largely due to improved patient outcomes and satisfaction. This procedure allows for real-time monitoring of neurological functions, which helps surgeons preserve critical cognitive, language, and motor abilities. As a result, patients tend to retain neurological functions closer to their baseline levels, highlighting the technique's advantages in modern neurosurgery. Neuromonitoring and brain mapping allow surgeons to perform resections more precisely in delicate anatomical areas. We developed and implemented a protocol for awake craniotomy procedures at the University of Mississippi Medical Center a few years ago. The purpose of this study was to assess and analyze the data between anesthetic management of awake craniotomy and traditional craniotomy (TC). We compared patient characteristics, anesthetic management, surgical duration, complications, opioid requirements, and length of hospital stay (LOS). Our results indicated a statistically significant reduction in the opioid requirement for patients in the awake craniotomy group with no difference in the overall length of stay.