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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 685-691
DOI: 10.4103/ajns.AJNS_61_21
Original Article

Performing awake surgeries in times of COVID-19 – A Singapore experience

Swati Jain
Division of Neurosurgery, University Surgical Cluster, National University Health System
,
Will Loh
1   Department of Anaesthesia, National University Health System
,
Hui-Minn Chan
2   Department of Psychological Medicine, National University Health System
,
Calvin Lam
3   Department of Rehabilitation, National University Health System
,
Tseng Yeo
Division of Neurosurgery, University Surgical Cluster, National University Health System
,
Lwin Sein
Division of Neurosurgery, University Surgical Cluster, National University Health System
,
Vincent Nga
Division of Neurosurgery, University Surgical Cluster, National University Health System
,
Kejia Teo
Division of Neurosurgery, University Surgical Cluster, National University Health System
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Introduction: It has been 17 years since the severe acute respiratory syndrome outbreak and Singapore is facing yet another daunting pandemic – the novel coronavirus (COVID-19). To date, there are 57,607 cases and 27 casualties. This deadly pandemic requires significant changes especially in the field of awake surgeries for intra-axial tumors that routinely involve long clinic consults, significant interactions between patient and multiple other team members pre, intra, and postoperatively. Materials and Methods: A retrospective review of all awake cases done during the COVID-19 pandemic from February to June 2020 was done. In this article, we outline the rigorous measures adopted during the COVID-19 pandemic that has allowed us to proceed with awake surgeries and intraoperative mapping at our institution. Results and Discussion: We have divided the protocol into various phases of care of patients planned for an awake craniotomy. Preoperatively, teleconsults have been used where possible thereby limiting multiple hospital visits and interaction. Intraoperatively, safety nets have been established during asleep-awake-asleep phases of awake craniotomy for all the team members. Postoperatively, early discharge and teleconsult are being employed for rehabilitation and follow-ups. Conclusions: Multiple studies have shown that with intraoperative mapping, we can improve neurological outcomes. As the future of the pandemic remains unknown, the authors believe that surgical treatment should not be delayed for intracranial tumors. Awake craniotomies and intraoperative mapping can be safely carried out by adopting the described protocols with combination of multiple checkpoints and usage of telecommunication.

Key-words:

Awake surgeries - COVID-19 - glioma - protocols

Financial support and sponsorship

Nil.




Publication History

Received: 14 February 2021

Accepted: 12 June 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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