Pediatric awake craniotomy for seizure focus resection with dexmedetomidine sedation-a case report

•Awake craniotomy can be done in pediatric patients as young as 11 years.•Proper preoperative assessment and counseling of patient and parents/guardian are essential.•Use of airway management devices can be avoided with proper planning and management.•Dexmedetomidine alone provides adequate sedation for entire procedure

Resection of lesions near the eloquent cortex of brain necessitates awake craniotomy to reduce the risk of permanent neurologic deficits during surgery. There are limited reports of anesthetic management of awake craniotomy in pediatric patients. This report is on use of dexmedetomidine sedation for awake craniotomy in a 11-year-old child, without any airway adjuncts throughout the procedure. Dexmedetomidine infusion administered at a dosage of 0.2 to 0.7 μg kg− 1 h− 1 provided adequate sedation for the entire procedure. There were no untoward incidents or any interference with electrocorticography, intraoperative stimulation, and functional mapping. Adequate preoperative visits and counseling of patient and parents regarding course and nature of events along with well-planned intraoperative management are of utmost importance in a pediatric age group for successful intraoperative awake craniotomy.