[Verse 1] Propofol drips, the cortex dims and slows, CMRO₂ drops, cerebral blood flow follows close, Thiopental burst suppression, metabolic shield, Ketamine reconsidered — neuroprotection revealed, Volatiles uncouple flow from metabolic need, Above one MAC the pressure starts to bleed, Nitrous oxide trapped inside a pneumocephalus space, So we cap it, cut it, pull it from the case [Chorus] Flujo cerebral, presión que hay que controlar, CMRO₂ coupled — protect the brain, don't stray, TIVA for the monitors, volatiles stay away, Mantén el objetivo, keep the physiology straight, Neuro-anesthesia — we co-manage every case [Verse 2] Awake craniotomy, the scalp block laid with care, Supraorbital, auriculotemporal, greater occipital there, Zygomaticotemporal, lesser occipital in the ring, Bupivacaine borders where sensation ends and mapping begins, Unstable cervical spine — videolaryngoscope preferred, Raised ICP on induction, ketamine's role is blurred, Fentanyl blunts the sympathetic surge on blade, Ramped position, preoxygenate, the airway plan is made [Chorus] Flujo cerebral, presión que hay que controlar, CMRO₂ coupled — protect the brain, don't stray, TIVA for the monitors, volatiles stay away, Mantén el objetivo, keep the physiology straight, Neuro-anesthesia — we co-manage every case [Verse 3] Adenosine bolus — cardiac standstill for seconds flat, Rapid ventricular pacing softens the aneurysm sac, Induced hypotension nearly shelved, the evidence fell thin, Vasopressors chosen by the pathology you're in, Normovolemia, isotonic fluid, glucose held below eight, Tranexamic acid, CRASH-3 told us, use it, don't debate, Transfusion threshold seventy, coagulopathy reversed, FFP and four-factor PCC when factor stores disperse [Bridge] Ahora el plan perioperatorio — apixaban en pausa, Coronary stents demand antiplatelets never at a loss, Hold the factor ten inhibitor, bridge the bleeding risk, Four-factor PCC on standby, andexanet in the list, Posterior fossa meningioma — dexamethasone pre-load, Antiepileptic prophylaxis, levetiracetam the mode, Multidisciplinary timing, cardiology consulted first, Stent thrombosis weighed against intracranial hemorrhage worst [Chorus] Flujo cerebral, presión que hay que controlar, CMRO₂ coupled — protect the brain, don't stray, TIVA for the monitors, volatiles stay away, Mantén el objetivo, keep the physiology straight, Neuro-anesthesia — we co-manage every case [Outro] PONV prophylaxis — ondansetron, dexamethasone already in, Opioid-sparing analgesia lets the neuro exam begin, Enhanced recovery — early extubation, warming, glucose controlled, Co-manage the physiology — that's the protocol we hold, Flujo y presión — the surgeon and the gas, Working the same language, every case we pass
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