Asleep-awake-asleep versus hypnosis for low-grade glioma surgery: long term follow-up outcome.

Abstract

BACKGROUND:

Hypnosis-aided craniotomy is a safe alternative to standard asleep-awake-asleep (AAA) surgery in glioma surgery. The impact of these two anesthetic methods on tumor prognosis has never been assessed.

OBJECTIVE:

This study aimed to evaluate the possible impact of the type of sedation (i.e., hypnosedation vs. standard sedation) on postoperative outcomes in awake surgery for gliomas.

METHODS:

Adult patients who underwent awake surgery for a diffuse glioma, excluding glioblastomas, between May 2011 and December 2019 at the authors' institution were included in the analysis. Pearson Chi-square, Fisher exact, and Mann-Whitney U tests were used for inferential analyses.

RESULTS:

Sixty-one (61) patients were included, thirty-one were female (50.8 %), and the mean age was 41.8 years (SD = 11.88). Most patients had IDH mutated tumors (n = 51; 83.6%). Twenty-six patients (42.6%) were hypnosedated while 35 (57.4%) received standard AAA procedure. The overall median follow-up time was 48 months (range: 10 months-120 months). Our results did not identify any significant difference between both techniques in terms of extent of resection (sub-total resection >95% rates were 11.48% vs. 8.20%, OR = 2.2, 95% CI = 0.62-8.44; P = 0.34) and of overall survival (87.5% of patients in the AAA surgery group reach 9 years OS vs. 79% in the hypnosis cohort, cHR = 0.85, 95% CI = 0.12-6.04; P = 0.87).

CONCLUSION:

Hypnosis for awake craniotomy is rarely proposed although it is a suitable alternative to standard sedation in awake craniotomy for LGGs, with similar results in terms of extent of resection or survival.

• Authors: Nourou Dine Adeniran Bankole, Ulrick Sidney Kanmounye, Abdessamad El Ouahabi, Ilyess Zemmoura
• Journal: Neuro-Chirurgie (Neurochirurgie) Vol. 69 Issue 6 Pg. 101494 (Nov 2023) ISSN: 1773-0619 [Electronic] France
• PMID: 37714375 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Elsevier Masson SAS. All rights reserved.

Topics

• Adult
• Humans
• Female
• Male
• Brain Neoplasms (surgery)
• Follow-Up Studies
• Wakefulness
• Retrospective Studies
• Glioma (surgery)
• Hypnosis (methods)