Usually day case skin surface surgery. LA provides much of the analgesia. 1-2hrs Pre-op Peri-op Post-op Alternatives
Tag Archives: Ondansetron
Robotic gynae surgery
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 Peri-op Post-op Alternatives
Robotic cystectomy
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
Microlaryngoscopy
20 minute day case ENT surgery. These patients often smoke. Shared airway. Discuss choice of airway device at the brief- options include: a subglottic jet ventilation catheter, microlaryngeal tube, injector needle on operator laryngoscope, or rarely a cricothyroidotomy needle. Pre-op Peri-op Post-op Alternatives
Lumbar spine decompression
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”
Brain biopsy
Distant airway with the head in pins. There can be a lull whilst waiting for intra-op confirmation of abnormal brain tissue, and there will be some time spent hair washing at the end. Pre-op Paracetamol Any symptoms the patient has been experiencing Peri-op 20G cannula Consider ergonomics – (e.g. induce on trolley and rotate afterContinue reading “Brain biopsy”
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
Trigeminal Nerve Radiofrequency Ablation
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
Lap appendix
Staple fodder of CEPOD. This recipe is for a straightforward lap appendix. Pre-op Peri-op Post-op Alternatives/ advanced techniques
Anaesthetic Recipes 