Awake craniotomy is a challenge as it requires vigilant monitoring.A 50 year old male with a space occupying lesion in left Temporoparietal region has come for Left Frontotemporal craniotomy under monitored anaesthesia care

50 year old male was premedicated with inj.midazolam 2mg iv,inj. Glycopyrrolate 0.2mg iv,inj.clonidine 75mg iv. Once patient was shifted to operation theatre all monitors were connected and supratrochlear,supraorbital, zygomticotemporal, auriculotemporal, greater occipital,lesser occipital nerve blocks were given. Intraoperatively was maintained with inj.fentanyl and inj clonidine .Tumor marking done with patient responding orally to our commands and excision of space occupying lesion was done near totally,immediate postoperative period patient was responding to commands.

Surgeon comfort, facilitate maximum amount of tumour excision

Ultimate successful anaesthesia for awake craniotomy depends on Anaesthesiologists personal experience and Planning with maximum attention