These are long (~6 hour) operations with the patient in a fairly steep head down position. The robot is completely unyielding, so the patient needs to be kept still throughout, with either regular muscle relaxant or a remifentanil infusion. Usually go to HDU afterwards as a level 2. Pre-op Peri-op Post-op Alternatives Out of fashion
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VP shunt
There will be a distant airway, head in pins, and the abdomen will be exposed. Use a forced air warming blanket as for abdominal surgery. Tunneling the line can be quite stimulating – increase the remifentanil or give a bolus of fentanyl before the surgeons do this. Pre-op Paracetamol Aetiology of hydrocephalus Intra-op Small cannulaContinue reading “VP shunt”
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These can be stressful situations. Ideally intubation is immediately followed by knife to skin, with the abdomen prepped before induction. There is a very high incidence of difficult intubation, and of awareness under anaesthesia in these situations. Pre-op Peri-op Post-op Alternatives
