bandage-green

Decompressive Craniectomy and Cranioplasty

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, arms tucked, head turned
Time : 2-4 hours (long)
Blood Loss : High (200 - 500 ml)
Post-op Pain : Moderate (4-6)
Maintenance Paralytic : Yes
Blocks : Scalp
Considerations : Aspiration risk / Full stomach, Arterial line, Central line, Mayfield Pins, High Blood Loss, PONV, Anticoagulation / Antiplatelet Therapy

Anesthetic Approaches

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

Positioning and exposure - supine with the head turned or supported on a roll, a large reverse question-mark scalp flap is raised over frontal, temporal and parietal bone. Bone flap - burr holes are...

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