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Oral case 85

Created: 3/11/2004

Pediatrics- tracheoesophageal fistula

A 3.5 kg neonate is scheduled for repair of a tracheoesophageal fistula.

1. Will you insist on a gastrostomy prior to induction of anesthesia? Why or why not?

2. How would you induce anesthesia?

3. Should awake intubation be performed? Why or why not?

4. What is the proper location of the distal tip of the endotracheal tube?

5. How do you ascertain proper positioning of the endotracheal tube?

6. After intubation, would you use controlled ventilation or allow the patient to breathe spontaneously?

Nerve injury

A 36-year old woman complains of unilateral leg weakness on the day after receiving an epidural for a vaginal hysterectomy. The gynecologist asks you whether this could have been caused by the epidural.

1. What is your reply?

2. How do evaluate the patient?

3. What do you tell the patient?

Anesthesia and liver disease

A 49-year old man with chronic active hepatitis is scheduled for gastric resection for carcinoma.

1. Would you choose a nitrous oxide/narcotic technique for general anesthesia?

2. Would volatile anesthesia be preferable? Why or why not?

3. Would halothane be acceptable?

4. What is the effect of halothane on hepatic blood flow?

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