bandage-green

Spinal Tumor Resection

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Prone, Lateral, Supine, arms tucked, arms extended and flexed (superman), Prone on a frame with the abdomen hanging free and the head on a foam cutout that leaves the eyes untouched.
Time : 2-4 hours (long)
Blood Loss : Very High (500+ ml)
Post-op Pain : High (7-10)
Maintenance Paralytic : An intubating dose only, then keep it off once exposure is done, because standard doses abolish motor evoked potentials.
Considerations : Arterial line, Central line, Fluoroscopy / Xray, High Blood Loss, MEP monitoring, SSEP monitoring, Opioid Tolerance

Anesthetic Approaches

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

Positioning and localization - most tumors are approached posteriorly with the patient prone on a frame, though an anterior vertebral body lesion may be done lateral through the chest or supine...

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