Awake Craniotomy Surgery at AIIMS Delhi

New Delhi: A five-year-old girl underwent awake craniotomy (conscious sedation technique) surgery for a left perisylvian intraaxial brain tumour at AIIMS Delhi on Saturday, becoming the youngest in the world to undergo this procedure.

Prof. Mihir Prakash Pandia, Dept of Anaesthesia, AIIMS, explained about the record-breaking surgery and said, "It was a case of insular cortex tumour. It was a brain tumour in a very small child and it was very challenging for us because generally, we do such cases under general anesthesia, which basically means fully anesthetic patient.

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But in this case, we used the technique called Awake Craniotomy (Conscious Sedation technique) surgery or sleep awake sleep technique. We don't give full general anaesthesia in this. We do around 16 nerve blocks, and then we give some sedation throughout the surgery because the child has to perform different tasks."

"We have to assess the motor function of the child, we have to assess the speech functions of the child. So throughout the surgery, we continuously communicate with the child and she remained comfortable," he added.

According to Dr Mihir, it was very challenging for them as they do awake Craniotomy in adult patients, but getting it done in a very small child was a very difficult task, adding "Getting a small injection in a child is difficult, then 16 nerve blocks and this surgery going throughout the patient remains a very challenging task for us because sometimes these blocks can fail in the interpretive period."

Dr Mihir further appreciated the patient, who, despite being so young, was cooperative throughout the procedure.

"The young patient was very cooperative throughout the procedure. She remained quite joyful and communicative throughout the procedure because you had to make her perform different tasks and we had to communicate with her throughout the surgery. So she was very cooperative otherwise," he added.

It was a team of around seven doctors who performed the surgery that took around three and a half hours.

"So from the anaesthesia team, I was there with one more professor, Professor Gyanendra Pal. There were a total of around 7 doctors with our paramedical staff and nurses, technicians were also involved. It took around three and a half to four hours for surgery," Dr Mihir said.

On brain tumor occurring in small children Dr Mihir said, "The parents if they see any kind of symptom or any serious symptoms, like seizures or severe headache or any kind of paralysis, should immediately consult a physician, neurologist, or neurosurgeon."

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