A short day-case neurosurgical procedure. Distant airway. Pre-op Paracetamol Peri-op 20G cannula Ideally induce on table, then rotate table after induction. Propofol TIVA Fentanyl ~ 200mcg total LMA Dexamethasone 6.6mg Ondansetron 4mg Post-op Regular paracetamol PRN codeine
Tag Archives: Fentanyl
Stroke Thrombectomy
This is the Cat 1 section of neuroradiology: every minute hundreds of thousands of neurons die. There needs to be meticulous maintenance of blood pressure. You will be in an unfamiliar environment- one of the IR theatres. GA is favoured here as there is a higher chance of clot retrieval and therefore better functional outcome.Continue reading “Stroke Thrombectomy”
Lap appendix
Staple fodder of CEPOD. This recipe is for a straightforward lap appendix. Pre-op Paracetamol NSAID Peri-op Any cannula for induction, upgraded to 16G asleep Modified RSI if indicated Fentanyl ~200mcg at induction, total ~300mcg by end Propofol ~150mg Rocuronium 1mg/kg ETT Sevoflurane maintenance 2-3g Magnesium into the IV fluids Dexamethasone 6.6mg Ondansetron 4mg towards endContinue reading “Lap appendix”
Incision and drainage of abscess – I&D
Staple fare of the CEPOD list, and usually a good starter for the day whilst more complex cases are worked up.
Renal Transplant
There’s an apocryphal tale about an inadequately relaxed patient “coughing” out their perilously perched transplant kidney at a key moment. As a result, the surgeons ask every few minutes whether we are “happy with the relaxation”. Pre-op Label fistula arm Establish “dry weight” and current weight Date of last dialysis Native urine output Co-morbidities –Continue reading “Renal Transplant”
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”
Day case “hot” lap chole
For the fit and well patient Pre-op Paracetamol Intra-op Propofol – Marsh TCI Remifentanil – Minto TCI Remi on first building up to 6ng/ml, wait two minutes, then propofol 6mcg/ml Atracurium 16G cannula COETT Depth of anaesthesia monitoring 350mcg fentanyl throughout case Post-op Fentanyl 0-200mcg in recovery Regular paracetamol Regular ibuprofen Tramadol or codeine AlternativesContinue reading “Day case “hot” lap chole”
