There will be a distant airway, head in pins, and the abdomen will be exposed. Use a forced air warming blanket as for abdominal surgery. Tunneling the line can be quite stimulating – increase the remifentanil or give a bolus of fentanyl before the surgeons do this.
Pre-op
- Paracetamol
- Aetiology of hydrocephalus
Intra-op
- Small cannula awake
- Large cannula asleep
- Propofol/ remifentanil TIVA
- Muscle relaxant
- Flexible ETT
- Forced air warmer placed as for open abdominal surgery
- Morphine ~ 7mg
Post-op
- Regular paracetamol
- PRN oramorph
- PRN anti-emetics
Alternatives
- Volatile anaesthesia with boluses of fentanyl – total ~350mcg throughout surgery
Anaesthetic Recipes 