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Oral case 110

Created: 19/1/2005

Epidural anesthesia for elective cesarean section

Sudden hypotension occurs during injection of local anesthetic.

1. What is the etiology?

2. The mother is immediately unresponsive. What do you do immediately? Do you intubate the trachea, or treat the blood pressure, or are both necessary?

3. How can you alter intubating drug regimens to accomplish intubation of the trachea with a nondepolarizing relaxant sooner than is usually necessary?

One can use three times the ED95 to overwhelm receptor sites, or one can use a priming technique whereby three minutes before the intubating dose, one-third of the ED95 is given. However, some patients may become apneic.

4. What is your rationale for drug choice?

Caudal analgesia in children

1. Is this a useful alternative to narcotic after peno-scrotal or inguinal surgery?

2. Is it useful in outpatients?

3. Does bupivacaine 0.25% produce motor block?

4. What is the duration of analgesia with and without epinephrine?

Click here.

Thiopental dose

1. What is the thiopental dose for a rapid sequence induction-intubation for a 70 kg male?

2. What is the thiopental dose for a rapid sequence induction-intubation for a 220 kg, 6-foot tall male?

3. Explain the difference in dosages.

4. Why is an induction dose lower in an 80-year-old than in a 40-year-old?

5. Describe in terms of central volume of distribution.

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