Aliases:
Transphenoidal pituitary tumour excision

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Antibiotics as per surgeons

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May 18, 2011
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Surgeons will use topical vasoconstrictors. Have phentolamine available in room to treat any hypertension

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Sep 28, 2014
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Hypocapnia may hinder surgery by reducing brain volume and pulling pituitary further away from view

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May 22, 2011
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Oral RAE endotracheal tube

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May 22, 2011
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Throat pack to collect airway blood.

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Sep 28, 2014
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If history of sleep apnoea, consider asking surgeon to place nasopharyngeal tube in under vision to aid in post-operative airway management.

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May 18, 2011
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Local anesthetic spray (eg Cophenylcaine) to vocal cords and trachea at intubation may help reduce coughing at extubation

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Oct 03, 2011
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Exposure to the abdomen on one side may be required to harvest a fat graft

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Sep 29, 2014
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Head will be most likely be placed in pins. Ensure adequate analgesia is on board at the time to minimise the sympathetic response.

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Oct 03, 2011
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Propofol plus Remifentanil TIVA to allow for rapid waking for neurological assessment.

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Sep 28, 2014
Morphine 0.05mg/kg (young) or fentanyl 0.5mcg/kg (elderly) 10min before end of case to prevent remifentanil hyperalgesia. (CM MMC)
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At risk of diabetes insipidus. Can cause periop hypovolaemia & hypernatremia.

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Sep 28, 2014
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Avoid manually ventilating patient after extubation as this risks the introduction of air through the surgical wound resulting in pneumocephalus. Ensure the patient is fully awake and any muscle relaxant reversed prior to extubation.

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Oct 03, 2011
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Remove the pins and throatpack whilst still deeply anesthetised to minimise the risk of coughing. Coughing may disrupt the surgical site and precipitate airway bleeding.

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