覚醒下手術—運動機能・言語機能

Assessment of Motor and Language Function during Awake Surgery

Point

・覚醒下手術の適応を決定する上で，術前の神経症状の評価が重要である．

・機能評価を行うにあたり，術中に容易に施行可能なタスクをあらかじめ患者と共有しておく．

・気道確保や体位など，覚醒下手術に特有の注意点があることを理解し，麻酔科医やリハリビテーション科と情報共有を行う．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2026年6月まで）。

　Awake surgery enables the evaluation of neurological functions that are difficult to assess with a conventional electrophysiological examination and is useful in the evaluation of language function. Awake surgery is a team effort involving anesthesiologists and rehabilitation physicians who evaluate motor and language functions, and information sharing during the perioperative period is important. Some points regarding surgical preparation and anesthesia methods are unique and must be well understood. For example, supraglottic airway devices must be used to secure the airway, and ventilation must be checked for availability when positioning the patient. Preoperative neurological evaluation is important in determining the method of intraoperative neurological evaluation, including choosing the simplest possible method of evaluation and sharing the information with the patient prior to surgery. Motor function assessment evaluates small movements that do not affect the surgery. Visual naming and auditory comprehension are useful in the evaluation of language function.