Difference between revisions of "Craniotomy for trauma"
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* Hypertonic saline | * Hypertonic saline | ||
* Head of bed position (as possible) | * Head of bed position (as possible) | ||
*Avoid using albumin due to increased mortality. | |||
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | ||
Revision as of 07:03, 18 July 2022
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access |
large bore PIV, arterial line, consider central line if poor peripheral access or long term infusions required, ICP drain/monitor |
| Monitors |
Standard plus arterial line and ICP monitoring |
| Primary anesthetic considerations | |
| Preoperative |
Full stomach, preop neuro exam |
| Intraoperative |
bleeding, ICP changes |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Provide a brief summary of this surgical procedure and its indications here.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Preop: CBC for baseline hemoglobin, CMP for electrolytes including sodium and potassium, INR given possible anticoagulants use
Intraop: Serial hemoglobin. Consider frequent Na checks if utilizing hypertonic saline, K checks if hyperventilating. TEG/coagulation studies as needed for resuscitation
Operating room setup
General anesthesia setup including fluid warmer/blood tubing, arterial line monitoring/setup, multiple infusion pumps, and consider ICP monitoring/drain as guided by neurosurgery.
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Needs arterial line
Consider ICP monitoring as guided by neurosurgery
Induction and airway management
Avoid increased ICP during induction
Positioning
Maintenance and surgical considerations
ICP monitoring and possible reduction including:
- ICP draining
- Hyperventilation
- Steroids
- Antileptics
- Mannitol
- Hypertonic saline
- Head of bed position (as possible)
- Avoid using albumin due to increased mortality.
Emergence
Postoperative management
Disposition
Neuro critical care unit
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |