61 What should be your primary concern during awake procedures? Airway protection Which two anesthetics work well during cortical mapping? Remifentanil and propofol combo. Baseline speech and neurology assessment are needed before procedure. Electrophysiologist for intraoperative monitoring of SSEPs, cortical mapping, monitoring motor and speech for tumors associated with respective areas. Which sedative hypnotic has less respiratory depression • Midazolam (GABA agonist) • Dexmedetomidine (α2-adrenergic agonist). Administration involves a bolus over 20 minutes, then use continuous infusion. Patients appear asleep but are readily aroused.1 How does dexmedetomidine work? By binding to α2-adrenergic receptors in the locus ceruleus What drug can be given preoperatively to prevent rebleeding until treatment choice (clipping or coiling) has been made? Tranexamic acid (1 g QID)2
Considerations for Neurosurgical Patients
61.1 Awake Procedures
61.2 Aneurysm Surgery
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