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.