Anaesthesia for awake craniotomy in covid 19 recovered patient with cerebral mucormycosis
Author(s): Dr. Dilshad Kauser
Abstract: A 71-year-old male patient with cerebral Mucor mycosis was referred from a local COVID-19 treatment facility. Written informed consent was obtained from the patient for publication of the patients’ details and images. The patient had an awake craniotomy and had a gross total tumour excision. There was no need to switch to general anaesthesia, The operation lasted four hours and thirty minutes. Throughout the awake craniotomy, the patient was haemodynamically stable, calm, cooperative, and comfortable. Amphotericin infusion administered at the end of the surgery, and Dexmedetomidine infusion administered after skin closure and the patient was completely awake and responsive when he was transferred out of the operating room and the patient's neurological condition improved post-surgery. On post-operative day 5, a repeat COVID-19 test came out negative, and the patient was discharged. A thirty-day post-operative assessment confirmed the patient's increasing motor gain. Although maintaining analgesia and hemodynamic stability with the patient awake was challenging, a target-controlled propofol infusion gave the required level of awareness, fentanyl titrated analgesia and sedation without drug accumulation, and bupivacaine blockade provided appropriate analgesia. We came to the conclusion that our patient's anaesthetic method was effective and It is possible to do an awake craniotomy in a COVID-19 positive patient with the requisite PPEs.