A solid dose of fentanyl up front 5-8mcg/kg, depending on the patient & the surgeon's speed.
Remi, remi and more remi to smooth out the BP spikes, plus whatever mix of volatile/iv anesthetic you like. Personally, I don't see the need for dex ($$$), especially if you have remi available.
Poking around up there is intensely stimulating, far out of proportion to their postop pain. Once the stimulation is over (i.e. they're through the sphenoid/clivus) they tend to settle out. So, ideally you can just turn down the remi. Or, you've burned yourself by overdoing labetalol/fent/dilaudid.
Ketorolac if the surgeons are OK with it.
Wakeup on remi and judicious doses of labetalol to minimize chances of a bleed/coughing/bucking.
