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

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. © 2016,sultan qaboos university. all rights reserved.