Awake Craniotomy Versus Surgery Under General Anaesthesia for Resection of Brain Tumour; A Systematic Review of Randomized Control Trials


  • Mahboob Khan Consultant Neurosurgeon Afridi Medical Complex, Peshawar
  • Abdul Hameed Khan Junior clinical Fellow, Royal Preston Hospital, UK
  • Farooq Sherzada Consultant Neurosurgeon, Afridi Medical Complex, Peshawar
  • Abdul Basit Khan Resident Dentist, Hayatabad Medical Complex, Peshawar
  • Laila Ghaffar Khyber Medical College, Peshawar, Pakistan
  • Nayyab Orakzai Department of Plastic Surgery, Hayatabad Medical Complex, Peshawar, Pakistan



Objectives:  To evaluate the clinical evidence on the comparison of results between an awake craniotomy and general anesthesia surgery for brain tumor removal.

Materials & Methods:  A systematic literature search was carried out using the PubMed, Cochrane Library, EMBASE, and MEDLINE databases using key terms such as awake craniotomy, awake brain surgery, awake craniotomy, anesthesia craniotomy, asleep craniotomy, asleep brain surgery, and general anesthesia. The PICO (Participant, Intervention, Comparison, and Outcome) approach was used to extract the studies contrasting the impact of awake craniotomy versus general anesthesia on outcomes included in this systematic review. PRISMA guidelines were followed throughout.

Results:  102 records were identified out of which 8 were included in the final qualitative synthesis (2 RCTs, Cohort). All reported neurological impairments in both groups, except 2. Six studies indicated early language abnormalities and early motor deficiencies. Six studies indicated early language abnormalities and early motor deficiencies. The mean operation time of the General Anesthesia group was more than that of Awake Craniotomy. Awake craniotomy surgery was associated with an average reduction of 4 to 8 days in the hospital.

Conclusion:  Under GA, AC (add abbreviations of these) offers a workable substitute for craniotomy for individuals with gliomas penetrating expressive areas; awake craniotomy with electrical stimulation is linked to improved long-term neurological and language abilities as well as a shorter hospital stay.


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