Repair of gastroschisis

A 3 kg neonate requires surgery to repair a gastroschisis.

1. How will you induce anesthesia?

2. Should an awake intubation be performed? Why or why not?

3. What anesthetic circuit will you use? Explain your rationale.

4. What type of fluid and at what rate will you administer it?

5. How will you prevent hypothermia?

6. Why is this important in a neonate?

Paraplegia

A 33-year old T4 paraplegic is scheduled for cystoscopy and crushing of urinary bladder stones.

1. Does he need anesthesia? Why or why not?

2. Will you use spinal or general anesthesia? Explain your rationale.

3. The surgeons prefer to proceed without anesthesia, and you are called STAT to treat a blood pressure of 280/140 mmHg. What is your differential diagnosis?

4. How will you confirm your diagnosis?

5. What is your treatment?

Sickle cell anemia

A patient with sickle cell anemia is scheduled for total knee replacement. The surgeon wishes to use a tourniquet.

1. What is your reply?

2. The preop hemoglobin is 9.5 gm/dL. Should this patient be transfused preoperatively? Explain.

3. What are the goals of transfusion in a patient with sickle cell disease?