ANESTHESIA FOR RUPTURED AAA REPAIR
Anesthetic choice:
General
Position:
Supine, arms out
Lines:
2 Large bore PIV if possible
1 Introducer
Arterial line
Pharmacology:
Vasopressors of choice
Blood products
Crystals/colloids
Ativan
NO HEPARIN
Tips:
-Send labs and type and cross if necessary before incision
-Be sure uncrossed blood is on the way or preferably in room
-Have perfusion set up their rapid infusor. (This machine can
give a liter a minute or more of volume, and warms it)
-Surgeon will prep and drape before induction
-If VS unstable, nice to have blood checked and hanging or in
the rapid infusor prior to incision
-Once incision is made, patients can become very unstable as
the tamponade on the aortic rupture is released before clamp
applied to aorta, really nice to have lots of help until clamped.
-Warming devices in place
-Often is a fluid resuscitation case more than anything
-Will take patient straight to CCU, no extubation
-Will need to keep in mind coags with excess blood
replacement and fluid administration either with coag profile or
with TEG from perfusion
Devised 4/04
Brewer
Ragab
Devised 4/04
Brewer
Ragab