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Neuroanesthesia Rotation
This rotation teaches residents how to provide anesthesia for neurosurgical
procedures. This requires an understanding of CNS physiology, of
the pathophysiology of neurosurgical disorders, of the procedures,
and of specific anesthetic techniques. Residents will be taught
these concepts and their practical application in a four week rotation
in their CA-2 year.
Interested residents can request an additional 3 month Advanced
Neuroanesthesia rotation in their CA-3 year. Aside from craniotomies
in the operating rooms, residents also get an experience in the
radioangiography suites to provide general anesthesia.
Residents are frequently involved in administration of anesthesia
for neurosurgical procedures outside the assigned neuroanesthesiology
blocks. In particular, exposure to emergent neurosurgery and neurotrauma
will be largely obtained during weekend and night call. Access to
the emergency neurosurgery cases at USC+LAC Medical Center, the
largest trauma center in the country, is the best experience for
our residents in program.
Location: LAC General Hospital; USC
University Hospital (advanced)
Goals
The goal of this rotation for the CA-2 is to teach the basic principles
of neuroanesthesia and make him/her comfortable with administration
of anesthesia for common and relatively straightforward neurosurgical
procedures.
The Advanced CA-3 rotation is intended for residents with
a special interest in neuroanesthesiology. The goal of the CA-3
rotation is therefore to provide the resident with a more in-depth
understanding of physiology and pathophysiology, as well as to provide
more experience with complicated cases. They will take it as a rotation
of several months, part of which will be used performing cases,
part acting as a fellow helping to teach junior residents, and part
on elective in related specialties (neuro intensive care, neuroradiology).
Details of the training program are worked out on an individual
basis.
After completion of this rotation, the CA-2 resident will:
Outline the head injury management protocol and perform, in practice,
those steps related to anesthetic practice.
Outline and perform in practice, the anesthetic management for the
following procedures:
- lumbar and cervical laminectomy,
- superior fossa exploration for tumor resection,
- transsphenoidal hypophysectomy,
- ventriculoperitoneal shunt placement or revision, and placement
of stereotactic frames,
- posterior fossa exploration,
- cerebral aneurysm clipping,
- resection of arteriovenous malformation,
- carotid endarterectomy, neuroradiologic procedures (including
embolization),
- stereotactic biopsy,
- cervical spine injury and spinal cord injury (acute and chronic),
- subdural and epidural hematoma.
After completion of this rotation, the CA-3 resident will:
Outline and perform in practice, the anesthetic management for
the following procedures:
- epilepsy surgery (including grid placement and temporal lobectomy),
- deep brain stimulation,
- craniofacial surgery,
- acoutis neuroma resection,
- major spine reconstruction,
- spinal tumor resection,
- surgery for myelomeningocele and Arnold-Chiari malformation.
- understand of the pathophysiology of neurosurgical diseases
(tumors, aneurysms, arteriovenous malformations, etc.).
- show proficiency in interpreting basic neuroradiologic studies
(CT and MRI).
- participate in academic activity relating to neuroanesthesia
resulting in a peer-reviewed publication.
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