Aliases:
Epilepsy surgery

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Considerations as for prolonged surgery, craniotomy, and patient with epilepsy.

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Try to avoid midazolam where possible as this may interfere with intraoperative cortical mapping

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3-8hrs

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arterial catheter for invasive blood pressure monitoring and repeated intraoperative blood tests

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central venous-catheter for central pressure monitoring

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Antibiotics as per surgeons

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Ensure normal CO2 during cortical mapping.
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Consider a postoperative opiate infusion for children too young for a PCA.

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If using volatile anaesthetic agent, surgeons may prefer isoflurane over sevoflurane due to their concerns around increased epileptiform EEG activity with sevoflurane which may interfere with ECoG (electrocorticography) mapping

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indwelling urinary-catheter

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Run noradrenaline to help titrate intraoperative blood pressure.

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Core temp probe will be required.

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Ensure normal temperature during cortical mapping.
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Orogastric tube on free drainage will be useful to minimise residual gastric contents, especially for patients in the prone position in which patients are frequently noted to have gastric fluid coming out of the mouth.

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Good review paper on Anaesthesia for temporal lobe epilepsy surgery. ether.stanford.edu/librar...

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