Neuro-anaesthesia tute part 3: craniotomy, ICP monitors, transphenoidal surgery, PACU emergency.

Thanks to all the trainees participating in this tute for the ANZCA part 2 exam!

We covered:

Awake craniotomy
craniotomy
Issues with surgical positions (prone, sitting etc)
ICP monitors
Transphenoidal surgery and
Recovery room emergencies

here is a great little summary of dexmedetomidine fro Life in the Fast Lane.
https://litfl.com/dexmedetomidine/

For more reading on awake craniotomy
https://academic.oup.com/bjaed/articl...
This article reinforces what we chatted about that the actual method is dependent on the varied range of circumstances

"There is no recognized consensus on the best anaesthetic approach to an awake craniotomy.7 This is often because the anaesthetist varies the technique dependent on the surgeon, pathology, length of surgery, and patient factors. Some neurosurgical centres have developed local practice pathways which allow selected patients to have an awake craniotomy as day surgery.

In a recent UK survey, 35% of anaesthetists reported their preferred anaesthetic approach as ‘asleep-awake’, 35% preferred ‘asleep-awake-asleep’, and the remaining 30%; used an ‘awake throughout’ approach"


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