Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Complications in Obstetric Anesthesia > Flashcards

Complications in Obstetric Anesthesia Flashcards

1
Q

What is the most common cause of pospartum maternal palsy?

A

Cephalopelvic disproportion which results in lumbosacral trunk compression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Are postpartum maternal palsies more common with or without anesthesia of any kind?

A

More frequent without anesthetic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 7 complications that can occur with neuraxial blocks?

A
  1. Epidural hematoma
  2. Epidural abscess.
  3. Chemical nerve injury
  4. Needle trauma
  5. Positioning injury
  6. Post Dural Puncture Headache (PDPH).
  7. High or total spinal anesthesia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F: Epidural hematoma can only occur with placement of the catheter and not removal?

A

False; can occur both periods of time so must be coagulating normally for placement and removal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is lowest acceptable platelet count for epidural placement?

A

100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which parturients are safe to receive neuraxial blocks?

A

No hx of bleeding. No si/sx of PIH.

And no anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If a parturient has PIH what is the lowest acceptable platelet and coags?

A

Platelets >100k and normal PT/PTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Wait for neuraxial block for how many hours if therapeutically anticoagulated?
Prophylactically anticoagulated?

A

24hrs

12 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 4 si/sx of epidural hematoma?

A
  1. Bilat leg weakness
  2. Incontinence
  3. Absent rectal sphincter tone
  4. Back pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is tx if suspected or confirmed epidural hematoma?

A
  1. Stat CT or MRI.

2. Surgical decompression within 6 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If an epidural abscess/infection is present, how many days before symptoms?

A

4-10 days for pain and loss of function to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is tx for epidural abscess?

A
  1. ABX

2. Laminectomy within 6-12 hrs of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 5 symptoms of epidural abscess?

A
  1. Sever back pain worse with flexion
  2. Local tenderness
  3. Fever/malaise/meningitis-like H/A and neck stiffness
  4. Lab changes- WBC/ESR increase, + blood cx
  5. Progression of si/sx over hours to days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is the epidural space so resistant to toxicity?

A
  1. Very vascular

2. Intact membrane between it and the SA space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drugs have been known to cause chemical nerve injury?

A

Thiopental, ephedrine, oxytocin, atropine, zantac, KCl,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are si/sx of TNS (Transient Neurological SYmptoms)?

A

Pain and dysethesia in buttocks, legs, calves following SAB

17
Q

What is most common cause of TNS?

A

High dose Lidocaine spinals and associated with lithotomy positioning.

18
Q

Where is the conus of the spinal cord located?

A

T12-L3

19
Q

Why should regional blocks not be done on sleeping patients?

A

Risk of needle trauma because they are unable to react to pain

20
Q

What are two common compression injuries parturients are susceptible to?

A
  1. Common peroneal nerve

2. Femoral/obturator nerve

21
Q

What typically causes common peroneal nerve compression?

A

Lithotomy stirrups

22
Q

What two nerve injuries can cause postpartum foot drop?

A
  1. Common peroneal nerve

2. Brow compression of lumbosacral trunk

23
Q

What will patient have difficulty doing if femoral nerve neuropathy?

A

Difficulty climbing stairs.

24
Q

Where would patient experience dec sensation if obturator neuropathy?

A

Upper inner thigh, and week hip adduction.

25
Q

What is typically onset of Post-Dural Puncture Headache (PDPH)?

A

48hrs (12-48)

26
Q

What 5 things increase risk of PDPH?

A
  1. Larger gauge needle
  2. Cutting edge needle.
  3. Younger age
  4. Cephalad or caudal orientation of Quincke needle
  5. Hx of PDPH or migraine.
27
Q

What is the mechanism of PDPH?

A

Loss of CSF causes sagging of intracranial contents and stretching of the pain sensitive tissues when the patient is in an upright posture.

28
Q

Which two needles have the lowest risk of PDPH?

A
  1. 24g Sprotte

2. 25g Whitacre

29
Q

What is the most common cause of peri-operative headache?

A

Caffeine withdrawal.

30
Q

Si/Sx of total spinal anesthesia?

A
  1. Hypotension
  2. Dyspnea
  3. Aphonia
31
Q

What is management of a suspected total spinal?

A
  1. Place pt left trendelenberg
  2. Early resuscitation,ventilation, and circulatory support
  3. Epi
  4. Naloxone for intraspinal opioid
  5. Intensive fetal/maternal monitoring
  6. May require urgent C-section
32
Q

What specifically accounts of 1/3 of anesthetic lawsuits in obstetric population?

A

Aspiration of gastric contents

33
Q

What are 5 preventative measures for aspiration in the parturient?

A
  1. Cricoid pressure
  2. Fasting/Elective c section (at least 6 hrs if regional planned)
  3. Na Citrate
  4. H2 blockers
  5. Reglan
34
Q

What is treatment of aspiration? 7

A
  1. ETT w/ pos press vent and PEEP
  2. Suction airway
  3. Rigid bronch
  4. Prophylactic ABX controversial
  5. NO prophylactic steroids
  6. Lavage is sometimes recommended
  7. Hypovolemia is expected= treat

Obstetrics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions