Scoliosis Sx

 Need two stage Sx, 1st anterior approach to release the anterior spinal artery, and
diskectomy, the 2nd stage to posterior  instrumentation
 The scoliosis could be secondary to muscular disease ( muscular dystrophy)
A Reflux RSI
B Restrictive lung disease,  risk of PPC (pneumonia, atelectasis)
C myopathy, arrhythmias
D avoid Sux
Heme consider autologus blood donation pre-op
 Consult (ICU, Heme), talk to the Pt regarding awake test
 Lab:CBC-D, Lytes, BUN, creat, X-match, CXR, PFT, ABG, ECG, Echo if needed
 OR: blood in the OR, bear hugger, Art-line, IV wormer
 Position: prone check all pressure points, and frequent checking
 May consider deliberate hypotension if there is no C/I, with that HR will , so
consider -blockers
 SSEP: if  latency by 10% or amp by 60%   BP, ask the surgeon to stop
 Volatiles have the least effect on SSEP  See SSEP card
 Post-op: pain, PPC, ICU