Neurosurgical Procedures

A. See also

Trauma, p. 119; Intracranial Hemorrhage, p. 61; Intracranial Pressure, p. 67; Spinal Cord, p. 113; Tumors of Brain, p. 120; PEDIATRIC Tumors, p. 151; PEDIATRIC Head Circumference, p. 137.

B. Neurosurgery pre-op orders

1. NPO except meds after midnight: IV fluids (D5NS); NGT to suction if urgent case.
2. Compression boots on call to OR.
3. Void on call to OR.
4. Pre-op meds: Consider:
- a. Steroids: E.g., dexamethasone 10 mg PO qhs, 10 mg IV on call. For pts on chronic steroids, give stress-dose steroids (see p. 173).
- b. Prophylactic Abx: E.g., 1 g cefazolin or vancomycin on call.
- c. GI prophylaxis: E.g., ranitidine 150 mg PO qhs, 50 mg IV on call to OR.
- d. Seizure prophylaxis: Phenytoin 100 mg tid for craniotomy/ hemicraniectomy, large/superficial ICH/tumor resection, seizure on presentation, etc.
- e. Sleeping pill: Beware of benzodiazepines in pts who are elderly or encephalopathic. Consider quetiapine.

C. Pre-op check

The pre-op note should document:

Jun 12, 2016 | Posted by drzezo in NEUROLOGY | Comments Off

Neupsy Key