Anaesthetic considerations in posterior fossa surgery . Dr. S. Parthasarathy MD., DA., DNB, MD ( Acu ), Dip. Diab . DCA, Dip. Software statistics PhD ( physio ) Mahatma Gandhi medical college and research institute , puducherry – India . What is it ??. Boundaries :.
Anaesthetic considerations in posterior fossa surgery
Dr. S. Parthasarathy
MD., DA., DNB, MD (Acu),
Dip. Diab. DCA, Dip. Software statistics
PhD (physio)Mahatma Gandhi medical college and research institute , puducherry – India
What is it ??
controlling voluntary and involuntary
motor activity like balance and locomotion
cranial nerve nuclei
Flow of CSF
anterior flexion, abducted and
No pressure in
1) Preoxygenation and self hyperventilation
2.) Thiopentone 3-4 mg/kg IV.
3.) Vecuronium 0.1 mg/kg IV and mask hyperventilation with oxygen and N2O (50:50) until neuromuscular blockade achieved. ISO CAN BE ADDED
4.) Lidocaine 1.5 mg/kg IV and additional thiopentone 2 mg/kg IV just before ET Intubation.
Dry but stable patient is optimum for tumor surgery.
open veins & non collapsible venous channels
gravitational effects of low CVP
neg. I.v. pressure relative to atm. Pressure
poor surgical technique
mannitol, hyperventilation, removal of SOL
CT scan confirms the diagnosis and localisation of intracranial air, if untreated Brain herniation and death.
Obstruction of its venous and lymphatic drainage
postop hypoxemia, hypercapnia