Cervical spine surgery

This chapter describes the investigations, premedication, intravenous access and monitors of the cervical spine surgery. It also describes the induction, intravenous fluids, reversal or elective mechanical ventilation and postoperative analgesia of the cervical spine surgery. The chapter discusses the goals of anesthesia to take precautions to prevent cervical spine injury during airway management and positioning and to facilitate smooth intubation and emergence. It focuses on the intraoperative concerns like maintenance of high-normal mean arterial pressures (MAPs); caution with excessive fluid administration if in prone position to minimize laryngeal edema. The chapter also focuses on the postoperative concerns like venous thromboembolism, skin breakdown, anemia, and postoperative visual loss after prone surgery. It explains that the patients with an uneventful intraoperative course can be reversed and extubated in the operating room (OR). For patients in the prone position for a prolonged period or if patient required large-volume fluid resuscitation during the case, a cuff leak test should be performed prior to extubation.