INTRODUCTION: Awake craniotomy (AC) is the standard approach for tumors of eloquent areas. However, concerns remain regarding the perioperative seizure risks and complications requiring general anesthesia (GA) or termination. METHODS: This retrospective cohort study included patients who underwent awake craniotomy for Glioma resection. Patients were divided into two groups based on their seizure control medication: Group S (N = 29) received one AED, while Group D (N = 26) received dual AEDs. We compared intraoperative seizures (IOS) and post-operative seizures (POS) rates between Groups S and D. Additionally, we evaluated the risk factors associated with POS and the 1-month post-operative Karnofsky Performance Scale (1M-KPS). RESULTS: This study considered a power of 0.9 so the effect size obtained was 0.866. 55 patients (41.8% female) with a median age of 39.0 (IQR 33.0-51.0) entered. The rate of IOS was 8 (27.6%) in Group S and 3 (11.5%) in Group D, with no statistically significant difference. (p = 0.137) POS occurred in 7 (24.1%) patients in group S and 2 (7.7%) patients in group D, (p = 0.100) pointing out no significant difference. The length of hospital stay (p = 0.606) and the length of ICU stay (p = 0.141), Post-op KPS, and 1M-KPS were not significantly different between the two cohorts (p = 0.131 and p = 0.217, respectively). The occurrence of POS was influenced neither by adjuvant therapy nor IDH1 mutation. The univariate and multivariate regression models showed pre-op KPS and the extent of resection had a significant effect on 1M-KPS. CONCLUSIONS: The addition of a second AED did not significantly affect POS prevention, IOS rate, or 1M-KPS improvement. Further research is needed for optimized strategies and improved patient outcomes.
No takes yet. Share an insight, caveat, or question.
Zandpazandi et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: