WikiAnesthesia - User contributions [en]

Parotidectomy

2022-04-05T01:37:35Z

Ed Nguyen:

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Overview ==

=== Indications: Tumor of parotid gland ===

=== Surgical procedure: Superficial: removal of parotid gland lateral to facial nerve. Total: removal of parotid gland lateral and medial to facial nerve, often combined with neck dissection. Radical: removal of parotid gland with facial nerve ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies: As indicated by H&P ===

=== Operating room setup: Facial nerve stimulator ===

=== Patient preparation and premedication: Routine ===

=== Regional and neuraxial techniques: N/A ===

== Intraoperative management ==

=== Monitoring and access: Standard monitoring, 18G PIV x 1 ===

=== Induction and airway management: Standard induction avoiding long acting paralytic (succinylcholine or remifentanil), ETT taped to opposite side. ===

=== Positioning: Supine, head turned to opposite side, bed may be turned 90 or 180 degrees ===

=== Maintenance and surgical considerations: Volatile anesthetic or TIVA, avoid long acting paralytic to allow for facial nerve, monitoring, consider remifentanil to maintain a still patient, facial nerve monitoring by surgeon ===

=== Emergence: ===

== Postoperative management ==

=== DispositionPACU ===

=== Pain management ===

=== Potential complicationsBleeding, infection, dysesthesia of greater auricular nerve, facial nerve weakness, Frey's syndrome ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|1.5-2
|
|-
|EBL
|25-200
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References: ==
[[Category:Surgical procedures]]

Rhinoplasty and/or septoplasty

2022-04-05T01:07:23Z

Ed Nguyen:

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Overview ==

=== Indications: Cosmetic or functional restoration of the airway ===

=== Surgical procedure: Remodeling of the nasal contour and/or reconstruction of the nasal septum ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|Nasal obstruction
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies: As Indicated by H&P ===

=== Operating room setup ===

=== Patient preparation and premedication: Standard ===

=== Regional and neuraxial techniques: N/A ===

== Intraoperative management ==

=== Monitoring and access: Standard monitors, 18G PIV x 1 ===

=== Induction and airway management: Standard induction and intubation, consider oral RAE tube per surgeon's preference ===

=== Positioning Supine, table may be turned 90 or 180 degrees. ===

=== Maintenance and surgical considerations Nasal cavity is often injected with lidocaine with epi by surgeons (some still use cocaine), both of which can elevate HR & BP. Volatile anesthetic or TIVA with muscle relaxant. Surgeons may place nasal splits or packing. Surgical time 1-2.5 hours. ===

=== Emergence Nose may be packed postop necessitating oral airway, suction oropharynx well before extubation as blood may collect in back of throat. ===

== Postoperative management ==

=== Disposition Routine PACU ===

=== Pain management ===

=== Potential complications Septal perforation, bleeding, infection ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|1-2.5
|
|-
|EBL
|Minimal
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Tympanoplasty and/or mastoidectomy

2022-04-05T00:50:08Z

Ed Nguyen:

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Overview ==

=== Indications: Repair perforated or damaged eardrum, remove mastoid air cells damaged by infection or cholesteatoma ===

=== Surgical procedure: Incision can be postauricular, endaural or transcanal ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|Possibly more prone to laryngospasm of associated with URI
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|Patients may have associated otitis or URI
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies As indicated by H&P, consider WBC if associated with URI ===

=== Operating room setup NIMS to monitor integrity of facial nerve ===

=== Patient preparation and premedication Standard premedication ===

=== Regional and neuraxial techniques N/A ===

== Intraoperative management ==

=== Monitoring and access Standard monitors, 18g PIV x 1 ===

=== Induction and airway management Standard induction, succinycholine for intubation (avoid long acting muscle relaxants), ETT ===

=== Positioning Supine, HOB often turned 90 or 180 degrees ===

=== Maintenance and surgical considerations Avoid long acting muscle relaxants, volatile anesthetic/TIVA, '''avoid''' N2O, remifentanil to maintain a still patient, dexamethasone and ondansetron as patients are prone to PONV ===

=== Emergence Avoid bucking and straining on ETT, consider deep extubation ===

== Postoperative management ==

=== Disposition Routine PACU ===

=== Pain management ===

=== Potential complications PONV, facial nerve injury ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Tympanoplasty and/or mastoidectomy

2022-04-05T00:49:04Z

Ed Nguyen:

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Overview ==

=== Indications: Repair perforated or damaged eardrum, remove mastoid air cells damaged by infection or cholesteatoma ===

=== Surgical procedure: Incision can be postauricular, endaural or transcanal ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|Possibly more prone to laryngospasm of associated with URI
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|Patients may have associated otitis or URI
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studiesAs indicated by H&P, consider WBC if associated with URI ===

=== Operating room setupNIMS to monitor integrity of facial nerve ===

=== Patient preparation and premedicationStandard premedication ===

=== Regional and neuraxial techniquesN/A ===

== Intraoperative management ==

=== Monitoring and accessStandard monitors, 18g PIV x 1 ===

=== Induction and airway managementStandard induction, succinycholine for intubation (avoid long acting muscle relaxants), ETT ===

=== PositioningSupine, HOB often turned 90 or 180 degrees ===

=== Maintenance and surgical considerationsAvoid long acting muscle relaxants, volatile anesthetic/TIVA, '''avoid''' N2O, remifentanil to maintain a still patient, dexamethasone and ondansetron as patients are prone to PONV ===

=== EmergenceAvoid bucking and straining on ETT, consider deep extubation ===

== Postoperative management ==

=== DispositionRoutine PACU ===

=== Pain management ===

=== Potential complicationsPONV, facial nerve injury ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]