Hatem B. Surgical treatment of brain gliomas of speech-motor area using wake-up anesthesia.

Dissertation is devoted to the questions of surgical treatment of brain gliomas of speech-motor area using wake-up anesthesia that allows preventing damage of brain functionally important areas, to promote radicalism of interventions and to improve patients' quality of life. 109 patients with brain gliomas of I-IV grade of anaplasia were operated in consciousness (main group), 60 - using traditional surgical methods (group of comparison). Indications and contra-indications for operations in consciousness were worked out. The reasons for neurological deficit origin were studied. Different variants of disease clinical flow at patients with brain gliomas, operated in consciousness without neurological deficit in future, were distinguished. Monitoring of speech and motor functions at patients, operated under wake-up anesthesia, allows to avoid or minimize damage of functionally important brain centers and to increase radicalism of operations. Wake-up anesthesia application assists to normalization of cellular immunity indexes, diminishing of circulatory immune complexes level that diminishes the expression of imunotoxicosis syndrome. Use of wake-up anesthesia removes a misbalance in the cytokine system that leads to recovery acceleration and prevents postoperative complications. The analysis of treatment cost of patients with brain gliomas testifies the considerable economic advantages of operations under wake-up anesthesia