The recovery time and cost of brain-tumor surgery might both be reduced if surgery is performed while patients are awake during part of the procedure, according to a new study conducted at The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
The study, published online June 18 in the Journal of Neurosurgery, examined the outcomes of 39 patients treated for glioma, a type of brain tumor that affects about 20,000 Americans annually. The doctors wanted to learn if surgeries that used conscious sedation - in which patients are initially anesthetized but restored to consciousness during surgery on the brain itself - had outcomes different from those using more traditional general anesthesia.
"Our data suggest that patients who received conscious sedation had shorter hospital stays than those receiving general anesthesia, and that this reduced the cost of treatment," says study leader Dr. E. Antonio Chiocca, professor and chair of neurological surgery and Dardinger Family Endowed Chair in Oncological Neurosurgery.
"This finding needs to be validated with a randomized prospective clinical trial, but if it holds true, it would mean that changing our current way of delivering anesthesia for these patients could allow them to leave the hospital sooner and save resources."
Neurosurgeons usually reserve conscious sedation for patients with tumors located near the brain's speech and sensorimotor centers, Chiocca says. The method was originally conceived as early as the 1950s to avoid or minimize the accidental damaging of these centers. Since then, additional studies have indicated that conscious sedation can result in more complications than procedures using general anesthesia, while others appear to show the opposite
To investigate the question, Chiocca and his colleagues studied the outcomes of 20 cases that used conscious sedation during surgery for stage II, III or IV gliomas and compared them with 19 cases that used general anesthesia.