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airway reflexes and smooth removal Typically ICU for frequent neuro exams Scalp block will provide analgesia for 12-16 hours If supplemental analgesia is required

prophylaxis See hemodynamic management section below Consider postoperative scalp block for analgesia Goals are to provide a stable hemodynamic anesthetic along

confound post-op neurologic exams Anxiolysis typically reasonable Avoid scalp blocks, as they may interfere with donor vessel blood flow Standard ASA monitors

If ruptured, risk of vasospasm highest 3-8 days after rupture Consider scalp block prior to emergence Acetaminophen Connolly, E. Sander; Rabinstein, Alejandro

Brachial plexus blocks Interscalene block Supraclavicular block Infraclavicular block Axillary block Digital block Wrist block Intercostal nerve block Pectoralis

Anesthesia type Scalp block MAC or Asleep-awake-asleep Airway Noninvasive O2 LMA/ETT if General Lines and access PIV x2 Large bore IV Arterial line Central