Difference between revisions of "Vagus nerve stimulation"
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Chris Rishel (talk | contribs) m (Text replacement - "|Respiratory" to "|Pulmonary") |
Ashwini Bhat (talk | contribs) (Added details) |
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{{Infobox surgical case reference | {{Infobox surgical case reference | ||
| anesthesia_type = | | anesthesia_type = General | ||
| airway = | | airway = ETT | ||
| lines_access = | | lines_access = PIV | ||
| monitors = | | monitors = Standard | ||
| considerations_preoperative = | | considerations_preoperative = | ||
| considerations_intraoperative = | | considerations_intraoperative = Risk of asystoly/ severe bradycardia due to vagus nerve stimulation. Injury to major vessels in neck can lead to massive hemorrhage | ||
| considerations_postoperative = | | considerations_postoperative = | ||
}} | }} | ||
Vagus nerve stimulator is an adjunctive therapy for refractile epilepsy. It is placed in the left cervical region. The generator/battery is placed in preaxillary area. | |||
== Preoperative management == | == Preoperative management == | ||
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=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> === | === Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> === | ||
labs guided by general physical condition of patient | |||
=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | === Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | ||
| Line 51: | Line 52: | ||
=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | ||
None. Incisions are small | |||
== Intraoperative management == | == Intraoperative management == | ||
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=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | ||
Supine | |||
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | ||
Isoflurane and Nitrous Oxide Maintenance preferred for rapid emergence to facilitate early neuro exam. | |||
Patient neuromuscularly blocked throughout to reduce risk of inadvertent injury. No neuromonitoring during procedure. | |||
=== 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. --> === | ||
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=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | === Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | ||
PACU f/b early discharge hoe or as prefeered by primary service | |||
=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | === Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | ||
Latest revision as of 16:59, 31 July 2022
Vagus nerve stimulation
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access |
PIV |
| Monitors |
Standard |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative |
Risk of asystoly/ severe bradycardia due to vagus nerve stimulation. Injury to major vessels in neck can lead to massive hemorrhage |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Vagus nerve stimulator is an adjunctive therapy for refractile epilepsy. It is placed in the left cervical region. The generator/battery is placed in preaxillary area.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
labs guided by general physical condition of patient
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
None. Incisions are small
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Supine
Maintenance and surgical considerations
Isoflurane and Nitrous Oxide Maintenance preferred for rapid emergence to facilitate early neuro exam.
Patient neuromuscularly blocked throughout to reduce risk of inadvertent injury. No neuromonitoring during procedure.
Emergence
Postoperative management
Disposition
PACU f/b early discharge hoe or as prefeered by primary service
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Ashwini Bhat and Chris Rishel