Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Miscellaneous issues• Everyone will need to consider the best way to transfer thepatient from standard monitoring and ventilating to the MRImonitor and gas supply, and back again.Neuraxial opiates[Appraised by Dr Edwin Borman, January 2010]Neuraxial opiates are a common component of good anaesthetictechniques. Fentanyl has a risk/benefit balance that favours its usewhen the patient returns to an acute ward after administration. Formorphine and diamorphine, see page Error! Bookmark notdefined..You may use intrathecal fentanyl in a dose of up to 25 µg as part of aspinal anaesthetic, or epidural fentanyl in a dose of up to 100 µg aspart of an epidural anaesthetic.The usual guidelines for monitoring recovery from anaesthesia onacute wards apply with no further precautions required due solely tothe use of fentanyl.Neuroradiological coiling procedures[Appraised by Dr Edwin Borman, January 2010]We offer three sessions per week for neuroradiological procedures.We do not currently offer emergency anaesthesia services foraneurysm coiling as the intention is to treat such patients during theroutine day on a dedicated list.If a request for such a procedure is made of the emergency team,refer it to the general consultant on call.Obesity guideline[Dr Madhu Srivastava, 2009]This guideline is firmly based on the AAGBI clinical guidelinePerioperative management of the morbidly obese patient, June 2007.Anaesthetists Handbook January 2010 213