Propofol anesthesia for awake craniotomy.

We discussed a case of awake craniotomy for removal of recurrent brain tumor near speech center, and used propofol as an anesthetic agent. The patient was 34-year-old woman. Tumor involved Broca's speech area, and Wernicke's area might be injured by tumor removal. Since the patient denied becoming total aphasia, we chose awake craniotomy to preserve her sensory speech function. Anesthesia was induced and maintained with propofol and fentanyl. Endotracheal intubation was performed. Once dura was exposed, propofol was discontinued to allowed to awaken. Surgeons performed brain surface mapping and removed the tumor. Although slight motor aphasia remained, the patient could communicate to other persons. Propofol. is a useful agent for awake craniotomy. Since it has a rapid plasma clearance and short context half time, rapid emergence from anesthesia can be anticipated. Patients could answer complex questions or requests, because they are well oriented and less excited and confused after the emergence. The issue to be discussed will be airway management in unintubated patients receiving sedation during awake craniotomy.