Often performed on patients who are not fit enough for an open repair. This is for elective cases
Pre-op
- Assessment of co-morbidities – often many
- Location of aneurysm relative to renal arteries
Peri-op
- Small and large cannula awake
- Arterial line awake
- Processed EEG for anaesthetic sparing
- Metaraminol infusion
- Propofol TCI or volatile anaesthesia
- Remifentanil TCI with either
- Muscle relaxant
- ETT
- Prophylactic antibiotics – give slowly as they drop BP
- 5000 units of heparin when surgeons ask for it
- Let them know that it has got around after 2 minutes
- Start a timer for 90 minutes. They may want a further 2000 units at this point if they are not close to finishing
- Unlike cardiac, it is not routinely reversed
Post-op
- Limb obs
- Usually HDU level care
- Not usually painful – surgeons infiltrate LA to puncture sites
Anaesthetic Recipes 