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Final clinical short case 22

Created: 26/10/2007
1. Conscious sedation
- What do you understand by conscious sedation?
- What drugs are used?
- What equipment is required before you give conscious sedation?
- To whom and where can conscious sedation be given?
- What monitoring would you use?
- What preparation is required for the patient – do they need to be fasted?
- What are the postoperative discharge criteria?
- What instructions would you give the patient?
- Are you aware of any guidelines?

2. Myotonic dystrophy
A 27-year-old male with myotonic dystrophy presents for dental extraction of a wisdom tooth under general anaesthesia. Discuss your anaesthetic management.

- Discuss the pathophysiology of myotonic dystrophy.
- What can precipitate myotonic dystrophy?
- Would you perform this operation as a day case?
- How would you anaesthetise the patient?
- Why would you not use vecuronium in this case?

3. Wolff-Parkinson-White (WPW) syndrome
- What is WPW?
- Describe the ECG in this condition.
- What are the common types of arrhythmias?
- What drugs should you avoid?
- Does ablation of the bundle require a general anaesthetic?

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