Preparation for Surgery for Supratentorial Ependymomas in Children

Preoperative Orders

• Standard

Anesthetic Considerations

• Assume elevated ICP:  These children typically have elevations in ICP, and anesthesia should take this factor into account when planning.  Halothane and nitrous oxide should be avoided, if possible.

Devices to Be Implanted

• Usually not required:  Implanted devices are usually not used in surgeries for these tumors.  One may choose to use plates and screws or other fixation devices to stabilize the craniotomy bone flap.

Ancillary/Specialized Equipment

• Microscope: Microscope and micro-instruments including the non-stick bipolar forceps should be available for the operation.
• Image guidance: Image-guidance equipment (ultrasound, computer-assisted image guidance).
• Intraoperative imaging: If available, intraoperative ultrasound, CT scanning, or MR imaging can be useful.