Awake Craniotomy: A New Airway Approach

Anesth Analg. 2016 Feb;122(2):509-11. doi: 10.1213/ANE.0000000000001072.


Awake craniotomies have been performed regularly at the University of Pennsylvania since 2004. Varying approaches to airway management are described for this procedure, including intubation with an endotracheal tube and use of a laryngeal mask airway, simple facemask, or nasal cannula. In this case series, we describe the successful use (i.e., no need for endotracheal intubation related to inadequate gas exchange) of bilateral nasopharyngeal airways in 90 patients undergoing awake craniotomies. The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway. Our purpose was to describe our experience and report adverse events related to this technique.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Management / adverse effects
  • Airway Management / methods*
  • Anesthesia / methods
  • Craniotomy / methods*
  • Female
  • Humans
  • Intraoperative Complications / epidemiology
  • Intubation / adverse effects
  • Intubation / methods
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / methods
  • Laryngeal Masks / adverse effects
  • Male
  • Middle Aged
  • Nasopharynx / physiology
  • Neurosurgical Procedures / methods*
  • Postoperative Care
  • Wakefulness
  • Young Adult