Quite long cases. The surgeons like good relaxation whilst taking the flap. Anticipate hypotension when they ask you to sit the patient up
Pre-op
- Paracetamol
Peri-op
- Keep warm
- 18G cannula on contralateral side
- Propofol/ remifentanil TIVA
- Muscle relaxant
- COETT and temperature probe
- Magnesium 3g
- TXA 1g
- Prophylactic antibiotics – may need repeat doses
- Paracetamol
- Oxycodone 10mg
- Anti-emetics – dexamethasone 6.6mg, ondansetron 4mg
- Aim for total IV fluid of 1.5-2 litres intra-operatively maximum
- TAP blocks by surgeons start and end
Post-op
- Analgesia
- Paracetamol
- Oxycodone immediate release 5-10mg, two hourly
- PRN anti-emetics
- Flap obs
- IV fluids
- Chewing gum and laxatives
Anaesthetic Recipes 