Posterior Fossa Craniotomy (Sitting) (not yet done before, these are lecture notes)
- Access
- PIV x2 large, pre-induction arterial line, central line with special multi-bore catheter for air aspiration
- Airway
- Oral ETT
- Induction
- Standard
- Maintenance
- TIVA (propofol/remifentanil/phenylephrine)
- Emergence
- Antibiotics
- Position
Notes
Venous air embolism is feared complication. Pre-cordial doppler, TEE (turn off when not in use). If encountered: 100% FiO2, supportive therapy, increase CVP with fluid, flood the surgical field, aspirate and visualize via TEE.
Avoid hyperflexion (possible quadriplegia).