Excision – Face

Anesthesia Implications

Position: Supine, arms tucked
Time: 1-2 hours (average)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: Ask surgeon

ETT vs LMA – The ETT is generally preferred. In some cases, excision of a cancerous patch may necessitate other procedures (like a lymph node biopsy and/or skin graft) which can make the procedure too long for an LMA.

Paralytics – Ask the surgeon. Some surgeons like to have leave the patient without paralytics to monitor function of the facial nerve.

Avoid surgical field – after intubation, ensure that the tube is clear of the surgical field.

Tucked Arms (general considerations): Consider a second IV – once the procedure has started, it’s going to be VERY difficult to handle IV issues – especially if your only IV has problems. Ensure the IV is running and monitors are still functioning after tucking the patient’s arms