DOI: 10.36347/sjmcr.2023.v11i04.017

Pages: 488-490

Providing adequate sedation while ensuring normoventilation is a challenge during an awake craniotomy. The use of sedative agents may cause hypoventilation and apnea, inducing hypoxemia and hypercapnia. High-flow humidified nasal oxygen delivery devices have shown positive results in various clinical areas. Here, we present two case reports of patients undergoing awake craniotomy who experienced a sudden decrease in oxygen saturation while receiving dexmedetomidine sedation. Despite being aroused to take deep breaths, the patients’ oxygen saturation did not return to baseline. Arterial blood gas analysis (ABGA) revealed a significant fall in partial pressure of oxygen. To address the hypoxemia, we initiated high-flow nasal oxygen (Optiflow) 10 L/min instead of conventional oxygen treatment via nasal prong. Follow-up ABGA results showed that Optiflow 10 L/min effectively provided adequate oxygenation and prevented the retention of carbon dioxide. Optiflow 10 L/min was successful in managing the patients’ hypoxemia while maintaining adequate oxygenation, ventilation, and sedation during awake craniotomy.