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Oral case 62

Created: 8/10/2004

Obstetrics- complications of labor epidural

During placement of a lidocaine epidural for labor pain, the parturient complains of lightheadedness and difficulty in breathing.

1. What is your differential diagnosis?

2. What is the treatment of intrathecal injection of 12 ml of 1% lidocaine?

3. The fetal monitor shows bradycardia. Is emergent cesarean section indicated?

4. What other measures would you take?

Reflex sympathetic dystrophy

A 40-year old man had a gunshot wound to the left lower extremity two months ago. He now presents with pain and trophic changes of the left foot.

1. How would you treat this patient?

2. How will you assess the success of a sympathetic block?

Penetrating eye injury

The patient has a full stomach.

1. Should surgery be postponed to allow gastric emptying? Why or why not?

2. Which factors contribute to increased intraocular pressure during induction?

3. Which factors contribute to increased intraocular pressure during intubation?

4. Can you prevent these factors from occurring? Explain.

5. Can postanesthetic nausea and vomiting be prevented? Explain.

6. How would you treat it?

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