E.g. hysterectomy, treatment of endometriosis. Can be part of a high turnover list, lasting 45-90 mins. Steep head down, need to be still whilst the robot is in use. Be familiar with emergency undocking procedures.
Pre-op
- Paracetamol
Peri-op
- 18G cannula
- Propofol/ remifentanil TIVA
- Muscle relaxant – rocuronium 1mg/kg
- ETT
- Dexamethasone 6.6mg / ondansetron 4mg
- Oxycodone 10mg 30-40 mins before the end
- Magnesium sulphate 2.5g
- Reversal with sugammadex
Post-op
- Oxycodone 1-10mg in recovery
- Regular paracetamol, regular ibuprofen
- PRN dihydrocodeine
- PRN oramorph if inpatient
Alternatives
- 20G cannula awake, 16G after induction
- Variations on muscle relaxation:
- Smaller dose of rocuronium (slower to reach intubating conditions, may need further doses intra-op, but might be able to reverse with glycopyrrolate/neostigmine)
- Atracurium (slower to reach intubating conditions but again might be able to reverse traditionally, or have even fully recovered as measured by TOF ratio by end of surgery)
Anaesthetic Recipes 