Nuss Bar Insertion

Nuss Bar Insertion

Anesthesia type
Airway
Lines and access
Monitors
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
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Overview

Indications

Pectus Excavatum

Surgical procedure

Nuss Bar insertion

Preoperative management

Patient evaluation

System	Considerations
Airway	ETT
Neurologic	Erector Spinae Block for chest wall pain
Cardiovascular	Potential for injury to heart and great vessels during placement of Bar. Place a large bore IV(16G) for possible need for resuscitation. Patient will have a pre-op echo to look at effect on cardiac function.
Pulmonary	Patients usually have a Pulmpnary function test or "CPET". Results often provide useful information on amount of restrictive disease
Gastrointestinal
Hematologic	Have Patient Typed & Screened
Renal
Endocrine
Other

Labs and studies

Have Type and Screen Ready. Usually Patient will have CBC ordered by surgery prior to case sttart, otherwise should order.

Patient preparation and premedication

Versed if necessary

Regional and neuraxial techniques

Erector Spinae Block

Postoperative management

Disposition

Patient will be admitted inpatient post surgery

Procedure variants

	Variant 1	Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications