P12.56.a a Prospective Investigation on the Tolerance of Awake Craniotomy Procedure in Patients With Brain Tumors

BACKGROUND Ensuring the highest possible quality of life for patients with brain tumors is one of the goals of modern neurosurgery. Several indirect techniques, such as fMRI or PET, can assess the brain’s functional organization prior to surgery; however, direct brain stimulation during awake craniotomy is the most dependable method for brain mapping. The objective of the present study was to assess the tolerance of this approach among the operated patients. MATERIAL AND METHODS The group consisted of 76 patients with gliomas (41 men and 35 women) in the age of 20-78, who were qualified for awake craniotomy procedure. Sixty-eight patients had a lesion in left (dominant) hemisphere, eight in non-dominant. Patients were asked to complete the Hospital Anxiety and Depression Scale (HADS) as well as ten-point visual analogue scales for pain and stress. Evaluation was performed two times: before and after the surgery. RESULTS Most patients tolerated the procedure well. The level of stress in the preoperative (M = 3,51; SD = 1,54) and intraoperative (M = 1,88; SD = 1,03) period was low. The patients’ assessment of intraoperative pain was also acceptable (M = 1,96; SD = 1,10) and in any case was it necessary to interrupt the operation. Moreover, study showed, that level of self-assessed pain was positively correlated with stress during the surgery (r = 0,28; p = 0,041) and scores of both: depression (r = 0,52; p = 0,011) and anxiety (r = 0,57; p = 0,004) subscales of HADS performed before the surgery. CONCLUSION Brain stimulation during awake craniotomy was well tolerated. The association between perceived pain and the preoperative level of anxiety and depression indicates an important role of the psychological components of the reported experiences. Extensive preoperative psychological preparation should be considered a key part of the procedure.