Resection of brain tumors may cause neurological sequelae, according to the site and size of the brain tissue removed. Awake craniotomy has been proposed as a surgical approach to satisfy criteria of radical surgery while minimizing eloquent brain damage. The most critical aspect of awake craniotomy is to maintain adequate patient comfort, analgesia, immobility and cooperation during a long surgical operation, ensuring in the meanwhile the safety, control and maintenance of vital functions. Apart from pharmacological, surgical, technical knowledge and skillfulness, the ability to maintain close psycho-emotional
contact and support with the patient throughout the operation is a fundamental task that the anesthesiologist has to pursue for the operation to be successfully managed.
This review summarizes the current opinion on anesthetic management of patients undergoing awake craniotomy.
Key words: anesthesia, awake craniotomy, brain mapping, brain tumor, neuro-oncology