374 LETTERSTOTHEEDITOR
Comment
to:
Awake
anesthesia
for
craniotomy:
case
report
Comentário
a:
Anestesia
para
craniotomia
em
paciente
acordado:
relato
de
caso
Deareditor,
Onthis occasion,Iwould liketocongratulatetheauthors ofthearticle entitled‘‘Awake anesthesiafor craniotomy: case report’’ recently published in the Journal Revista BrasileiradeAnestesiologia.1Reading thearticle in
ques-tion, proposed as a case report, aroused some pertinent questions. The authors, when describing the anesthetic technique,reportedtheuseofSchnider’smodelfor propo-foltarget-controlledinfusion associated withremifentanil target-controlled infusion using Minto’s model; however, they did not report how the patient’s airway was man-aged.The doses used in thecase wereelevated in order nottocompromiseventilation;furthermore,theimportance of maintaining the patient awake throughout the proce-dure was not clear. As they used brain mapping, which was the patient’s participation in the procedure? In this case, it was also not specified which type of mapping wasperformed, asanesthetic drugs interferesignificantly in certain monitoring. During the procedure, maintaining thepatientinRamseysedationstage2---3compromiseshis
participationduringtherequestedtests.Itisrecommended that the patient be awake, responsive to requests, and collaborative.2Takingintoconsiderationthetopic’s
impor-tance,thelearningopportunitywithacasereportandthe basisforfutureanesthesiaareofgreatimportancetoclarify thesepoints.
References
1.BolzaniND, Junqueira DOP, Ferrari PAF,et al. Anestesia para craniotomia em paciente acordado: relato de caso. Rev Bras Anestesiol.2013;63:500---3.
2.Volquind D, Dalmina D. Microcirurgia de tumor cerebral com pacienteacordadoutilizandoatécnica‘‘Asleep-Awake-Asleep’’. RevAMRIGS.2010;54:453---6.Availableat: http://www.amrigs. com.br/revista/54-04/017-544Microcirurgia%20de%20Tumor.pdf
[accessed11.12.13].
DanielVolquinda,b
aSociedadeBrasileiradeAnestesiologia,RiodeJaneiro,
RJ,Brazil
bUniversidadedeCaxiasdoSul,CaxiasdoSul,RS,Brazil
E-mail:danielvolquind@gmail.com
Availableonline2July2014
