Pre-Op:  Art line & 2 IV’s for all transphenoidal’s and all craniotomies. Type and Cross

Anesthesia:  VERY VERY important to control blood pressure at induction and at emergence. He requests some sort of drip during case such as propofol or precedex. Nicardipine drip at closure. Consider deep extubation if patient is a candidate. Consider a syringe of Nitroglycerine for emergence. VERY IMPORTANT THAT BP DOES NOT SPIKE. Goal SBP< 140 at extubation Mannitol on standby.

Post-Op: