Article
Optimal time window for cortical mapping in awake craniotomy – a two-centre study – updated database
Optimales Zeitfenster für kortikales Mapping bei der Wachkraniotomie – eine zweizentrige Studie – aktualisierte Datenlage
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Published: | June 4, 2021 |
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Objective: In our previous study we have demonstrated that the optimal time window for cortical mapping in a Sleep-Awake-Awake (S-A-A) craniotomy might begin 20 minutes after extubation of the patient. The assessment of time window beyond 40 minutes after extubation was not possible due to the lack of data. During the last year we have accumulated additional data in order to assess a longer intraoperative time window. In cooperation with Tata Memorial Hospital, we have acquired the data about intraoperative reaction speed during Awake-Awake-Awake (A-A-A) craniotomy.
Methods: Reaction speed was assessed in 102 Patients in S-A-A and 18 Patients in A-A-A group. The registration was done with an application Reaction Time Sampler in both groups. Statistical analysis with SPSS v24.0 (IBM, New York, U.S.).
Results: The preoperative (preOP) reaction times (RT) of S-A-A patient cohort (665 ± 333ms) were significantly shorter than those measured during surgery (intraOP) (815 ± 379ms; p<0,001).
In the S-A-A cohort, a one-factorial ANOVA (within) showed a significant increase during surgery (p <0.001). There was a significant difference between the average preOP RT and the reaction speed during the timeframes 0-10min and 10-20min after extubation.
In the A-A-A cohort, the difference between the preOP and intraOP reaction time was insignificant.
Conclusion: Patients in the S-A-A cohort react significantly slower during surgery than preoperatively.
The intraOP reaction times were not significantly longer than preOP in A-A-A cohort. Furthermore, the reaction time in S-A-A cohort was significantly longer during the timeframes 0-10min and 10-20min after extubation. Hence, according to our data the optimal time window for cortical mapping in S-A-A craniotomy possibly starts 20 minutes after the extubation.