These can be done with either a GA or a spinal- there appears to be no mortality benefit of one over the other. The key is to deliver one excellent anaesthetic and not do a combination of the two. Pre-op Check they have been reviewed by ortho geris team There are very few reasons toContinue reading “Hip fracture surgery- for neck of femur fracture/ NOF – GA”
Category Archives: Uncategorized
Robot Assisted Laparoscopic Radical Prostatectomy- RALP
These patients are positioned in a steep Trendelenburg position. A non-slip gel and shoulder bolsters help prevent slipping. Pre-op Spinal GA Facial swelling from steep Trendelenberg PO paracetamol Peri-op 16G cannula in non dominant hand Art line only for patient factors Spinal – 1.5ml 0.5% heavy 0.5% L-bupivicaine + 700mcg diamorphine (total 2.2ml) Prop +Continue reading “Robot Assisted Laparoscopic Radical Prostatectomy- RALP”
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 Counsel about nerve block, emphasising the need to take analgesia before the block wears off Peri-op 20GContinue reading “Shoulder surgery”
Pituitary surgery
Pre-op Paracetamol Intra-op Sat up shared airway Armored tube Wide bore IV access Steroids Post-op Rapid smooth emergence
Day case TIVA
My default day case recipe Pre-op Paracetamol Ibuprofen Intra-op 20G cannula 1% propofol with 1mg alfentanil per 50ml (20mcg/ml) Marsh TCI Start at 6 Insert LMA Turn down to 4 Fentanyl 0-100mcg Dexamethasone 6.6mg Ondansetron 4mg Post-op Fentanyl 0-200 mcg in recovery Regular paracetamol and ibuprofen PRN anti-emetics Notes Propofol alfentanil admixture is fully inContinue reading “Day case TIVA”
