General information on what happens as a patient is being prepared for neurosurgery?

Question

What does the patient have to do? Not eat anything? Have

their head shaved? etc, what happens in the operating theatre before

they go under the knife.

I'm interested in things from a patients viewpoint.

Answer 1

I've never been a NS patient, but I anesthetize patients for neurosurgery.

All surgical patients need to be NPO (nothing by mouth) prior to surgery.  That's to prevent aspiration (inhaling your vomit).  Everybody also gets an IV, unless you're a small child.

Depending on the procedure, imaging studies may need to be done.  There are devices that match CT scans to intraoperative location of tumors, so we send people down to get a CT with special markers on their head, so the CT can be matched to the surgical field.  That's done on the morning of surgery, right before going to the OR.

http://www.brainlab.com/scripts/website_...

We shave heads (only the area that's being cut) after the patient is asleep and in pins (device that holds the head still during surgery)

This picture shows the holder:

http://www.medicon.de/uploads/tx_anappet...

The pins go into the skull.  Patient is usually asleep for pin placement, but may be just sedated and local anesthetics used.

We used to shave half the head, but the guys I work with now don't do that.  They just shave a patch where the incision i going to go.

Sometimes we have to put extra lines a patient before they go to sleep (extra IV, arterial line, central line) but that is usually done after they go to sleep.  (We try to be a nice as we can, as long as it's safe)

Many patients get pre-operative sedation, and don't remember a whole lot after the IV goes in.

Hope that helps.