Conscious Experience and Psychological Consequences of Awake Craniotomy.

Abstract:

BACKGROUND:Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain. METHODS:This study aimed to investigate the occurrence and course of psychological sequelae following awake craniotomy (AC) for brain tumors in a series of 20 patients using a broad, validated psychological assessment preoperatively, intraoperatively, postoperatively and a standardized follow-up of 3 months. In addition, the association of the preoperative psychological condition (including, but not limited to, anxiety and fear) with perioperative pain perception and interference was assessed. RESULTS:AC did not induce any shift in the median levels of anxiety, depression, and stress symptoms already present prior to the procedure. Furthermore, anxiety and depression were all moderately to strongly associated over time (all P < 0.05). Stress symptoms also correlated positively over all times of measurement. Stress 3 days after surgery was strongly associated with stress 3 months after surgery (P < 0.001), whereas the correlation between preoperative and immediate postoperative stress showed a statistical trend (P = 0.07). Preoperative fear was not related to intraoperative pain, but to pain and its interference with daily activity on the third postoperative day (P < 0.001 and P < 0.01, respectively). CONCLUSIONS:Postoperative psychological symptoms clearly correlated with their corresponding preoperative symptoms. Thus, mental health was not negatively affected by the AC experience in our series. Intraoperative fear and pain were not related to the preoperative psychological condition. However, preoperative fear and anxiety were positively related with pain and its interference with daily activity in the immediate postoperative period.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Hejrati N,Spieler D,Samuel R,Regli L,Weyerbrock A,Surbeck W

doi

10.1016/j.wneu.2019.05.156

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

e381-e386

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)31433-0

journal_volume

129

pub_type

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