Sage NK) Remifentanil in low dosage and if necessary supplementation with propofol. (Exact dosage NK) No medication NA Remifentanil 0.3 g kg-1 min-Nossek 2013 [43]NANAPLOS ONE | DOI:10.1371/journal.pone.0156448 May 26,Initial: remifentanil 0.7 g kg-1 min-1, bolus propofol (median 200mg) until loss of eyelid reflex, followed by continuous propofol 0.17 mg kg-1 min-1, order U0126 Thereafter 50 reduction of remifentanil and propofol Initial: Propofol 1? mg kg-1, lidocaine (0.5?.5 mg kg-1 and Nutlin (3a) site fentanyl 1? g kg-1. Thereafter: Propofol 100?50 g kg-1 min-1 and remifentanil 0.05?0.09 g kg-1 min-1. Initial: Propofol 1? mg kg-1, lidocaine (0.5?.5 mg kg-1 and fentanyl 1? g kg-1. Thereafter: Propofol 100?50 g kg-1 min-1 and remifentanil 0.05?0.10 g kg-1 min-1. NA Group A (n = 33) 3/1998?2/200,2 bolus titration of propofol and remifentanil or fentanyl, plus midazolam. Group B (n = 46) after 2/2002, only fentanyl (50g) boluses slowly until the minimum dose of 10 g kg-1 in the first 1 h, followed by fentanyl 1 g kg-1 every further hour (n = 43) NA No medication TIVA (Propofol + remifentanil) NA No medication TIVA (Propofol + remifentanil) No No LMA or nasal trumpets (spontaneous breathing) No No LMA or nasal trumpets (0,5?,0 FiO2, spontaneous breathing), during awake phase only 0,21 FiO2. Until 2002 no medication, after 2002 adapted fentanyl boluses After 2002 repeated boluses of fentanyl No No Spontaneous breathingOlsen 2008 [44]TIVA (propofol + remifentanil)Ouyang 2013 [45]TIVA (Propofol + remifentanil + fentanyl)Ouyang 2013 [46]TIVA (Propofol + remifentanil + fentanyl)Pereira 2008 [47]NA(Continued)Anaesthesia Management for Awake Craniotomy18 /Table 3. (Continued)Dosage SA(S) Anaesth. depth control Airway OAA/S and BIS Oxygen via nasal trumpet, connected to the ventilator (spontaneous breathing) MAC /AAA Management Awake phase End of surgery Use of muscle relaxants NoStudySA(S) ManagementPeruzzi 2011 [48]NANAInitial: dexmedetomidine 0.1?.7g kg-1 h-1 and if needed: 0.1mg kg-1 midazolam, thereafter bolus propofol until loss of consciousness, followed by a continuous application of propofol 40?20 g kg-1 min-1 combined with dexmedetomidine 0.1?0.7g kg-1 h-1. Sevoflurane 0.5? was added, to reduce propofol. BIS aim 50?0. Propofol (dosage NK) No medication Propofol if required No NoOnly titrated dexmedetomidine infusion and fentanyl 12.5?5 g if needed for pain Additional propofolPinsker 2007 [49]NANAOxygen via nasal cannula (spontaneous breathing) No No 2-8l min-1 oxygen via nasal airway and nasal cannula. (spontaneous breathing)PLOS ONE | DOI:10.1371/journal.pone.0156448 May 26,Initial: Propofol 50?250 g kg-1 min-1 and dexmedetomidine 1 g kg-1 loading dose (in 10?5 min.). Thereafter Propofol 50?50 g kg-1 min-1 and dexmedetomidine 0.4?0.7 g kg-1 hr-1. Initial: propofol 0.1?0.3mg kg-1, then continuously 0.025?0.05 mg kg-1 min-1. Fentanyl 50?00g and midazolam 1-2mg titrated as needed. NA Continuous propofol (1? mg kg-1 h-1) and fentanyl 1? g kg-1 hr-1 or remifentanil 0.01?.25 g kg-1 hr-1 NA Cessation propofol only NA No medication Resuming propofol induction and continuous infusion, with fentanyl and midazolam as needed. Resuming propofol infusion NA NK Cessation propofol, reduction/ cessation of dexmedetomidine and 25?0g fentanyl, if required for pain (fentanyl mean ?SD 169.8 g ?80.32g) No No Spontaneous breathing, oral airway only described for 5 patients No No 6l min-1 oxygen via face mask Dexmedetomidine 0.02?0.5 g kg-1 hr-1, propofol 30?80 g kg-1 hr-1 and remifen.Sage NK) Remifentanil in low dosage and if necessary supplementation with propofol. (Exact dosage NK) No medication NA Remifentanil 0.3 g kg-1 min-Nossek 2013 [43]NANAPLOS ONE | DOI:10.1371/journal.pone.0156448 May 26,Initial: remifentanil 0.7 g kg-1 min-1, bolus propofol (median 200mg) until loss of eyelid reflex, followed by continuous propofol 0.17 mg kg-1 min-1, thereafter 50 reduction of remifentanil and propofol Initial: Propofol 1? mg kg-1, lidocaine (0.5?.5 mg kg-1 and fentanyl 1? g kg-1. Thereafter: Propofol 100?50 g kg-1 min-1 and remifentanil 0.05?0.09 g kg-1 min-1. Initial: Propofol 1? mg kg-1, lidocaine (0.5?.5 mg kg-1 and fentanyl 1? g kg-1. Thereafter: Propofol 100?50 g kg-1 min-1 and remifentanil 0.05?0.10 g kg-1 min-1. NA Group A (n = 33) 3/1998?2/200,2 bolus titration of propofol and remifentanil or fentanyl, plus midazolam. Group B (n = 46) after 2/2002, only fentanyl (50g) boluses slowly until the minimum dose of 10 g kg-1 in the first 1 h, followed by fentanyl 1 g kg-1 every further hour (n = 43) NA No medication TIVA (Propofol + remifentanil) NA No medication TIVA (Propofol + remifentanil) No No LMA or nasal trumpets (spontaneous breathing) No No LMA or nasal trumpets (0,5?,0 FiO2, spontaneous breathing), during awake phase only 0,21 FiO2. Until 2002 no medication, after 2002 adapted fentanyl boluses After 2002 repeated boluses of fentanyl No No Spontaneous breathingOlsen 2008 [44]TIVA (propofol + remifentanil)Ouyang 2013 [45]TIVA (Propofol + remifentanil + fentanyl)Ouyang 2013 [46]TIVA (Propofol + remifentanil + fentanyl)Pereira 2008 [47]NA(Continued)Anaesthesia Management for Awake Craniotomy18 /Table 3. (Continued)Dosage SA(S) Anaesth. depth control Airway OAA/S and BIS Oxygen via nasal trumpet, connected to the ventilator (spontaneous breathing) MAC /AAA Management Awake phase End of surgery Use of muscle relaxants NoStudySA(S) ManagementPeruzzi 2011 [48]NANAInitial: dexmedetomidine 0.1?.7g kg-1 h-1 and if needed: 0.1mg kg-1 midazolam, thereafter bolus propofol until loss of consciousness, followed by a continuous application of propofol 40?20 g kg-1 min-1 combined with dexmedetomidine 0.1?0.7g kg-1 h-1. Sevoflurane 0.5? was added, to reduce propofol. BIS aim 50?0. Propofol (dosage NK) No medication Propofol if required No NoOnly titrated dexmedetomidine infusion and fentanyl 12.5?5 g if needed for pain Additional propofolPinsker 2007 [49]NANAOxygen via nasal cannula (spontaneous breathing) No No 2-8l min-1 oxygen via nasal airway and nasal cannula. (spontaneous breathing)PLOS ONE | DOI:10.1371/journal.pone.0156448 May 26,Initial: Propofol 50?250 g kg-1 min-1 and dexmedetomidine 1 g kg-1 loading dose (in 10?5 min.). Thereafter Propofol 50?50 g kg-1 min-1 and dexmedetomidine 0.4?0.7 g kg-1 hr-1. Initial: propofol 0.1?0.3mg kg-1, then continuously 0.025?0.05 mg kg-1 min-1. Fentanyl 50?00g and midazolam 1-2mg titrated as needed. NA Continuous propofol (1? mg kg-1 h-1) and fentanyl 1? g kg-1 hr-1 or remifentanil 0.01?.25 g kg-1 hr-1 NA Cessation propofol only NA No medication Resuming propofol induction and continuous infusion, with fentanyl and midazolam as needed. Resuming propofol infusion NA NK Cessation propofol, reduction/ cessation of dexmedetomidine and 25?0g fentanyl, if required for pain (fentanyl mean ?SD 169.8 g ?80.32g) No No Spontaneous breathing, oral airway only described for 5 patients No No 6l min-1 oxygen via face mask Dexmedetomidine 0.02?0.5 g kg-1 hr-1, propofol 30?80 g kg-1 hr-1 and remifen.
