Protonix IV

40mg reconstituted in 10cc NS ivp over 2-3 minutes

AV Fistual

Usually can be done under MAC.

Heparinization

Reverse with Protamine. (0.25mg - 1mg) of Protamine per 100 unit of heparin depending how long ago the heparin was given. Max dose 50mg.
Do not exceed rate of 5mg/minute

D & C

Oxytocin 20 units not to run too quickly to avoid hypertension.

Adrenalnectomy

Potential for blood loss.

Lateral position.

Steroid replacement hydrocortisone 100mg.

Craniotomy

Type and cross 2 units of blood.
Use normal saline for fluid.
Do not volume over load the patient. However the patient does have increase urine due to mannitol, and occasionally lasix is given.  Therefore the I & O should be balanced.

Check with surgeon regarding

Decadron
Mannitol 0.5-2g/kg - usually come in 25g bottles
Keppra - 1 vial 500mg TRO 15 minutes

Some surgeon use Optisome with ultrasound to help visualize the tumor.

Propofol 100mg can be given before head pinning.

References:

Perioperative Management of Complex Skull Base Surgery: the Anesthesiologist's Point of View

Endovascular AAA

ETT

A line

Heparin

Hold respiration during contrast injection to visualize the aorta.

Thoracoscopic Lobectomy

A line

Type and Cross 2 units prbc 
Left sided double lumen tube
35
37
39
41
Fluid restriction < 1 liter

Male 39F if > 170cm then 41F

Female 37F if < 160cm then 35F

170cm patient insert tube to 29cm. For every 10cm in height insert tube 1cm deeper, for every 10cm shorter in height insert 1cm less. 
Insert double lumen tube, twist left.
Inflate tracheal cuff.
Check end tidal CO2.

Make sure have clamp

Drop lung as soon as in later decubitus position.

Glidescope Intubation

1 - Mid-line Insertion
2- Insert styleted tube under direct vision - invert the curve if necessary. First from the side then turn along the curvature of the scope.
3 - Guide the tube under video. Cricoid pressure instead of lifting otherwise the larynx becomes more anterior.
4 - Insert the tube as the stylet comes out.

Cepacol Lozenges for sore throat

Management of DM medication and Insulin

Hold all oral hypoglycemic agents the day of surgery.

Only Thiazolidiediones (Actos, Avandia) and DPP-IV (Januvia, Onglyza) can be given the morning of the surgery.

Patient on insulin - half of morning intermediate or long acting insulin. May need glucose infusion.

Spinal Anesthesia for Total Joints

Bupivicaine 0.75% 1.6cc = 12mg
Duramorph 0.1mg

Bupivicaine 0.5% 2.5cc = 12.5mg
Duramorpha 0.1mg

For longer cases

15mg with epi wash or 0.2mg epi

Should last 2.5 hours

Use Isobariac for hip

If only hyperbaric bupivicaine available
For knee - tilt table 15 degrees to operative side
For hip - position patient operative side down for 3 minutes, then while supine for foley tilt table to operative side.

Tranexamic acid contraindicated in patients with PTCA and stent

Nubain 5-10mg Q4 for pruritis

Horacek - no duramorph, tranexams acid 1gm in 50cc ivpb 

Metta prefer GA and Vancomycin and toradol

Gerhart - spinal without duramorph. Tranexamic acid x 2, toradol

Banffy- spinal + ga. Ask for muscle relaxation. +/- femoral nerve block. No duramorph.

Kevin Ehrhart - Spinal no duramorph, 2 doses of Tranexamic Acid

Moreland- Spinal with 100mcg Duramorph