Clinical Procedure
 
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Contraindications include: Highly anxious patient, inability to lie still for several hours, uncooperative, language barrier, low occipital tumour (requiring prone position), and inexperienced surgeon. refl.in/e3

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Procedures where extensive dural resection will be required can be quite painful. For those procedures, an awake technique is a relative contraindication.

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Requires a cooperative, calm & communicative patient

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If surgeon considers this patient at high risk of venous air embolism, consider insertion of central venous line with tip positioned at junction of IVC and RA for an attempt to aspirated air if required.

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Patient needs to be able to lie flat for a prolonged period. Supine joint pain or orthopnea will make this difficult.

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Scalp block is painful. Perform under sedation or general anesthesia.

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Prolonged procedure. Monitor temperature, apply warm air blanket and use fluid warmer.

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