Anesteziološki postupci kod budne kraniotomije

master's thesis

• Title (english): Anesthesiological procedures in awake craniotomy
• Author: Petra Sedinić
• Mentor: Ante Sekulić (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Ante Sekulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Budna kraniotomija je operacijski zahvat pri kojem se na početku operacijskog zahvata uklanja dio lubanje s ciljem osiguravanja dostupnosti intrakraniju te se pri završetku on vraća na svoje originalno mjesto (1), a pacijent je budan tijekom dijela ili cijelog operacijskog zahvata. Danas je ovaj pristup populariziran zbog njegovih beneficija u operacijskim zahvatima ''elokventnih'' regija mozga. Kada govorimo o premedikaciji u budnoj kraniotomiji, tu nema konsenzusa i jasnih smjernica je li ju potrebno davati, te ukoliko je potrebno koje lijekove u tu svrhu koristiti. Također nije postignut konsenzus između stručnjaka koji je najbolji farmakološki pristup ovome zahvatu. Danas poznajemo 3 farmakološka pristupa budnoj kraniotomiji; SAS pristup koji kombinira GA i budnost prilikom mapiranja, MAC pristup tijekom kojeg je pacijent sediran i AAA pristup koji kombinira lokalne anestetike i analgetike. Usporedbom sva 3 anesteziološka postupka dolazimo do zaključka kako su SAS i MAC pristup podjednako sigurni i povoljni za pacijenta te koja će se od ovih dviju tehnika koristiti ovisi isključivo o operateru i anesteziologu. Za AAA tehniku je potrebno provesti dodatna istraživanja.

Abstract (english)

An awake craniotomy is a surgical procedure during which we remove a section of the skull in order to access the intracranial compartment. At the end of the procedure, the section of the skull is returned to its previous place (1) while the patient is awake during the entire or part of procedure. Today, this approach is widely used because of its benefits in the surgical procedures of eloquent regions in the brain. In terms of premedication for the awake craniotomy, a general consensus on whether its administration to the patient is necessary or which medication should be administered has not been reached yet. Furthermore, the consensus on which pharmacological technique is the best for this procedure has also not been reached. Today, we have the knowledge of three different techniques for the awake craniotomy: the SAS technique, which combines GA and the awake period during mapping; the MAC technique, during which the patient is under sedation; and AAA technique
which combines the local anesthetics and analgesics. When comparing these three anesthesiological techniques, we can conclude that the SAS and MAC techniques are equally safe and favorable for the patient, but which of these techniques will be used depends only on the surgeon and the anesthesiologist. However, the AAA technique requires further research.

• Keywords: budna kraniotomija; asleep-awake-asleep; monitored anaesthesia care; awake-awake-awake; mapiranje
• Keywords (english): awake craniotomy; asleep-awake-asleep; monitored anesthesia care; awake-awake-awake; mapping
• Language: croatian
• URN:NBN: urn:nbn:hr:105:787601
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-12-18 17:08:29