Pain

Question 1

Chronic pain users and fentanyl patch part of regimen. Recommendations for surgery?

Answer 1

Continue fentanyl patch in OR.

Question 2

Lidocaine toxicity

Answer 2

Initial presentation: personal numbness/tingling

Later sxs: cardiac arrhythmia, seizures

Tx: 20% lipid emulsion

Question 3

Induction agent reduces risk of PONV and improves bronchodilation, provides sedation and antegrade amnesia without analgesia

Answer 3

propofol

Question 4

Induction agent not used in lap procedures and causes increased PONV

Answer 4

nitrous oxide (accumulates in pneumoperitoneum)

Question 5

Induction agent used for tight blood pressure control

Answer 5

Etomidate

Question 6

Postdural puncture headache

Answer 6

after dural puncture
loss of CSF into epidural space, decreased hydrostatic pressure and traction on meninges

sxs: b/l, frontal, retro-orbital, occipital headache w/ photophobia and nausea, positional
tx: epidural blood patch (inject 15-20mL of autologous blood into epidural space at or 1 level below level of dural puncture causing stop of leakage of CSF fluid into epidural space)

Question 7

Case where anesthetic agent abruptly stopped when patient was still intubated. difficulty ventilating patient, arrested, given epi and had ROSC. what happened?

Answer 7

abrupt reversal of anesthetic agent due causing severe bronchospasm