Craniectomy for craniosynostosis repair

2026-03-22T22:38:27Z

Specoraro: Added types of craniosynostosis and completed quick reference box

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT
| lines_access = 2 PIVs
| monitors = Standard + arterial line
| considerations_preoperative = Type and screen/cross with blood products on call
| considerations_intraoperative = May/may not be syndromic associated, airway may be difficult.
| considerations_postoperative = May stay intubated based on amount of blood loss/blood products transfused. Will likely stay inpatient and recover in an ICU setting.
}}

A '''craniectomy for craniosynostosis repair''' is performed to correct the premature fusion of one or more cranial sutures.

Types of craniosynostosis (decreasing order of frequency)<ref>{{Cite book|title=Anesthesiologist's Manual of Surgical Procedures}}</ref>:

1) Scaphocephaly: Premature fusion of sagittal suture

2) Brachycephaly: Premature fusion of coronal suture

3) Trigonocephaly: Premature fusion of metopic suture

4) Posterior plagiocephaly: Premature fusion of lambdoidal suture

== Overview ==

=== Indications ===
Craniosynostosis is the premature fusion of one or more cranial sutures, resulting in abnormal skull development and head shape.

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Deep brain stimulation lead placement

2026-03-15T21:45:16Z

Specoraro: Added additional information to maintenance of anesthesia

{{Infobox surgical procedure
| anesthesia_type = General or awake
| airway = ETT or natural airway if awake
| lines_access = 1-2 PIV
| monitors = Standard, 5-lead EKG
| considerations_preoperative =
| considerations_intraoperative = If under MRI guidance, will need MRI-safe equipment. Keep very still for MRI images
| considerations_postoperative =
}}

Subthalamic nucleus deep brain stimulation (DBS) lead placement is a neurosurgical procedure whereby leads for DBS are placed in the subthalamic nucleus to help control the tremors of Parkinson disease.

==Overview==

===Indications===
Parkinson disease

===Surgical procedure===

==Preoperative management==

===Patient evaluation===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

===Labs and studies===

===Operating room setup===

===Patient preparation and premedication===

===Regional and neuraxial techniques===

==Intraoperative management==

===Monitoring and access===

*Standard ASA monitors
*1-2 IVs

===Induction and airway management===
Induce general anesthesia with ETT if MRI guidance will be used.

If awake, patient should be kept calm and told to hold as still as possible. Consider dexmedetomidine bolus.

===Positioning===
Supine, typically head 90 or 180 deg away

===Maintenance and surgical considerations===
If lead placement is guided by MRI, must use MRI-compatible monitors and machine. Consider hefty doses of NDMBs to maintain maximum stillness for better image quality.

If awake, consider dexmedetomidine infusion to assist. Goal is to keep patient still but not disinhibited. May also consider remifentanil and/or propofol gtts. to alter level of sedation relatively quickly.

===Emergence===

==Postoperative management==

===Disposition===

===Pain management===

===Potential complications===

==Procedure variants==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Indications
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

==References==

[[Category:Surgical procedures]]

WikiAnesthesia - User contributions [en]

Craniectomy for craniosynostosis repair

Deep brain stimulation lead placement