bandage-green

Chiari Decompression

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Prone, Sitting / Beach Chair, Lateral, arms tucked, Head fixed in Mayfield pins with the neck flexed; nothing about head or tube is adjustable after draping.
Time : 2-4 hours (long)
Blood Loss : Moderate (50 - 200 ml)
Post-op Pain : High (7-10)
Maintenance Paralytic : Fine for pinning and the bony work; confirm with the surgeon before redosing if cranial nerve or motor traces are running.
Considerations : Arterial line, Mayfield Pins, PONV, Venous Air Embolism

Anesthetic Approaches

1GETT, TIVA, Propofol Drip, Remifentanil Drip
2GETT, 1/2 MAC Gas, Remifentanil Drip
The Surgery

Positioning and fixation - the patient is placed prone, three-quarter prone or sitting, and the head is held in Mayfield pin fixation with the neck flexed to open the suboccipital window the whole...

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