A 59-year-old woman with a frontal glioma and papilloedema is listed for craniotomy. She is drowsy but obeys commands. CT shows midline shift and

Question

A 59-year-old woman with a frontal glioma and papilloedema is listed for craniotomy. She is drowsy but obeys commands. CT shows midline shift and effaced basal cisterns; sodium is 138 mmol/L and PaCO2 before induction is 5.1 kPa. What is the most appropriate anaesthetic technique?

Accepted Answer

Induce with measures to maintain CPP and reduce intracranial pressure

Answer

Give hypotonic maintenance fluid to reduce sodium

Answer

Perform single-shot spinal anaesthesia before craniotomy

Answer

Allow marked hypercapnia during mask ventilation

Answer

Use nitrous oxide to reduce volatile anaesthetic requirement

Raised intracranial pressure for craniotomy — FRCA Final MCQ

A 59-year-old woman with a frontal glioma and papilloedema is listed for craniotomy. She is drowsy but obeys commands. CT shows midline shift and effaced basal cisterns; sodium is 138 mmol/L and PaCO2 before induction is 5.1 kPa. What is the most appropriate anaesthetic technique?