Cerebral Palsy Patient for CT-Guided Renal Biopsy

You are providing anaesthesia in the interventional radiology suite of your major hospital. On the list is a 22-year-old woman who requires a CT-guided biopsy of a left renal mass that was discovered incidentally on abdominal imaging. The patient was admitted today for the procedure and is accompanied by her parents who are her legal guardians and carers. A postoperative bed has been booked for the patient. Medical History Severe cerebral palsy - spastic quadriplegia - moderate intellectual disability Recurrent aspiration pneumonia - severe gastro-oesophageal reflux - oropharyngeal dysphagia - gastrostomy feeding tube (feeds ceased for six hours) Anxiety - distress with medical procedures Epilepsy Medications Baclofen 10 mg tds Levetiracetam 1000 mg bd Pantoprazole 40 mg once daily Allergies Nil known Observations height 155 cm estimated weight 40 kg estimated (BMI approx. 16.6 kg/m2) HR 90 bpm BP 95/55 mmHg SpO2 96% on room air Preoperative Investigations Blood test results are normal Blood Group and Hold has been conducted