These might be performed by neurosurgeons, or by orthopaedics. The patient will be lying prone, with their arms out in front. Pre-op Often have chronic pain, note current analgesic regime Note any neurology Explain post-op PCA Peri-op Propofol/ remifentanil TCI Rocuronium Flexible ETT Prophylactic antibiotics Prone, arms out front Magnesium Morphine up to 20mg Consider:Continue reading “Lumbar spine decompression”
Category Archives: Orthopaedics
Knee arthroscopy
Pre-op Often young, fit and well Day case Paracetamol and ibuprofen Peri-op 20G cannula LMA Fentanyl – 150mcg, then 100mcg just before knife to skin Propofol TCI Dexamethasone 6.6mg Ondansetron 4mg Consider adductor canal block if doing more than just arthroscopy, e.g ACL reconstruction Post-op Fentanyl in recovery Oramorph TTO paracetamol, NSAID, codeine
Ankle fusion / arthrodesis
Pre-op Paracetamol Peri-op 20G cannula Prophylactic antibiotics Popliteal block – up to 20ml 0.5% L-bupivicaine fentanyl 100-200mcg Propofol TCI LMA Anti-emetics- dexamethasone 6.6mg + ondansetron 4mg Post-op Paracetamol Codeine Aspirin 150mg OD
Arthroscopic knee repair – e.g. ACL repair
Often young, fit and well. Shorter repairs can be done with an LMA. Day case. Pre-op Often young, fit and well Consent for block Paracetamol and ibuprofen Peri-op 20G cannula Fentanyl ~200mcg Propofol Muscle relaxant ETT TIVA or volatile maintenance Adductor canal block- up to 20ml 0.25% L-bupivicaine Dilute anaesthetic infiltrated by surgeons at theContinue reading “Arthroscopic knee repair – e.g. ACL repair”
Shoulder surgery
These cases have a distant airway (feet closest to machine), and are generally sat up in a “beach chair” position. As a result, the main concerns surround loss of airway and cerebral hypoperfusion. They are often intubated. Pre-op Peri-op Post-op
TKR – Total Knee Replacement
The focus here is on early mobilisation and discharge, using enhanced recovery protocols. Patients tend to have been well briefed to expect a spinal +/- sedation
THR – Total Hip Replacement
The focus here is on early mobilisation and discharge, using enhanced recovery protocols. Patients tend to have been well briefed to expect a spinal +/- sedation
Anaesthetic Recipes 