The craniotomy patient is awake, and the reason why the patient has no pain is that he has been injected with anesthetic.

In the field of neurosurgery, this is not a "significant technical progress", and brain surgeons should choose it as an anesthesia method for surgery according to different patients' conditions.

This operation method is called "conscious skull surgery", which focuses on the change of anesthesia and adopts "conscious anesthesia during operation". This anesthesia is usually used for intraoperative cortical electroencephalography, or for craniotomy requiring accurate electrophysiological monitoring (which can be used in epilepsy surgery, movement, sensation, speech, cognition and other functional fields, intractable central pain, deep electrode implantation adjacent to or located in functional areas) and other major purposes, so as to protect functional areas of the brain more accurately and reduce postoperative sequelae. Relatively speaking, this kind of operation is relatively narrow.

In fact, this is a misunderstanding caused by ignorance of anesthesia. In neurosurgery anesthesia, we usually combine intravenous anesthesia with inhalation anesthesia to provide favorable conditions for anesthesia, hypnosis, muscle relaxation and other anesthetic effects. When the patient mentioned in this case woke up during the operation, the drug stopped was actually just a kind of "severe hypnosis" drug. After the pause, the patient regained consciousness and received a small amount of continuous analgesia. Because of persistence, the patient woke up during the operation and felt no pain.

A skull that requires cortical EEG or accurate electrophysiological monitoring and operates near or within the functional area. Similarly, under normal circumstances, the surgical method should choose general anesthesia. The basic principles of neurosurgery anesthesia are: providing the best operation state, maintaining appropriate perfusion pressure and brain cell oxygenation. If the patient is always awake, it is more difficult to control intracranial pressure, which will increase the risk of surgery. In short, in most craniotomy, it is unnecessary or unsafe to stay awake unless it is used for specific surgical needs.