Lines

• A-line
• male-male Luer + stopcock (to check stump pressure)
• CVC/PAC only if bad heart
• PIV x 2 (one for infusions only, other for bolus meds only): 20G is big enough.

Infusions (all on pumps):

• carrier (usu. NS)
• nipride and/or NTG
• phenylephrine
• ±remifentanil

Technique

• Usually vascular surgeons prefer regional, but have a LOW threshold for choosing GA - surgery is long, position is uncomfortable, and it's hard to switch to GA midstream (potential difficult airway) ... you MUST be confident that the patient will be able to tolerate the procedure
• Regional
• Superficial cervical plexus block
• ±deep plexus block (not for Prasad)
• CNS monitor: conversation, squeezebag or rubber ducky
• MINIMAL sedation - talk to the patient the entire time
• General
• "routine" induction/maintenance
• avoid swings in BP ... opioids?
• CNS "monitor": EEG (SEF95), stump pressure
• Need to wake patient up, assess mental status at end ... plan appropriate anesthetic