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Oral case 58

Created: 5/10/2004

Gas analyses during anesthesia- methods and usefulness

Your colleague proposes that the hospital install a mass spectrometer for the operating room, for anesthetic circuit gas analysis.

1. Is this reasonable?

2. How does a spectrometer work?

3. What are alternatives?

4. What is the clinical usefulness?

5. When is knowledge regarding FEN2 useful?

Use of nerve muscle stimulators

Your colleague rarely uses a stimulator, because he relies on a succinylcholine drip for relaxation, and has never had a problem.

1. Do you agree with this? Explain.

2. What response would be seen with a stimulator?

3. What response would be seen with a stimulator if a nondepolizer were used?

4. What is the clinical correlation of nerve stimulation?

5. How would you use a muscle stimulator in an awake patient?

High frequency ventilation

1. Are there definite clinical applications for high-frequency jet ventilation?

2. What are disadvantages of this technique?

3. Your resident suggests that it would be useful in extracorporeal shock wave lithotripsy. What is your reply?

4. How do you monitor the adequacy of ventilation and oxygenation with this technique?

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