Evidence map›Paper›PMID 40186120›Full record

ArticleBMC anesthesiology2025

Role of modified enhanced recovery after surgery (mERAS) in awake craniotomy performed under monitored anesthesia care (MAC); a single center retrospective study.

Adel Azghadi, Megan Sharpe, Katrina Mikofalvy, Mohamed El-Abtah, Kerrin Sunshine, Varun Shah, Mart Andrew Maravillas, Tiffany R Hodges, Xueqin Ding

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In one paragraph

Article in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Adel AzghadiDepartment of neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Megan SharpeSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Katrina MikofalvySchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Mohamed El-AbtahSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Kerrin SunshineDepartment of neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Varun ShahDepartment of neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Mart Andrew MaravillasDepartment of Biostatistics, University Hospitals Clinical Research Center, Cleveland, OH, USA.
Tiffany R HodgesDepartment of neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Xueqin DingDepartment of Anesthesiology, Metrohealth Medical Center, Case Western Reserve University, 2500 Metrohealth Dr, Cleveland, OH, USA. xxd77@case.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aims to explore the safety and efficacy of awake craniotomy procedures under monitored anesthesia care (MAC), focusing on the impact of modified Enhanced Recovery after Surgery (ERAS) protocols on patient outcomes.

methodsPatients undergoing elective awake craniotomy between 2017 and 2022 were divided into two groups: those receiving the ERAS protocol after 2020 and a control group of pre-2020 patients. Factors examined included demographics, intraoperative awakening time, procedure durations, pain management, hospital stay length, complications, discharge disposition, and follow-up symptoms.

resultsFrom 2017 to 2022, 61 patients underwent awake craniotomy using MAC anesthesia at University Hospitals Cleveland Medical Center, with 23 receiving the ERAS protocol after 2020. Demographics were comparable between the control and ERAS groups. Total awake time, time to wake up, and total procedure time showed no significant differences (P > 0.05). Awake craniotomy was discontinued in 8 cases due to anxiety and pain (mERAS = 1, Control = 7). The mERAS group experienced fewer cases of awake failure, nausea/vomiting, and postoperative cognitive and speech deficits, though these differences were not statistically significant. No significant differences were found in postoperative pain medication consumption, complications, or length of hospital stay (P > 0.05).

conclusionsAwake craniotomy under MAC with a modified ERAS protocol is feasible but did not show statistically significant improvements in patient outcomes. Further research with larger sample sizes and multi-center collaboration is necessary to draw more definitive conclusions.

Indexed as

AnesthesiaCraniotomyEnhanced Recovery After SurgeryAdultAgedFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesWakefulnessAwake craniotomyBrainEnhanced recovery after surgeryFailureMonitored Anesthesia Care

Identifiers

PMID40186120
PMCPMC11971890

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.