Obstetrical anesthesia

A 38-year old woman with a history of mitral stenosis requires urgent cesarean section for cephalopelvic disproportion.

1. Would a regional technique be preferable to general anesthetic?

2. Compare epidural vs spinal.

3. An epidural is performed, and the blood pressure drops to 80/60 mmHg. What is your management?

Extracorporeal shock wave lithotripsy

1. You have administered an epidural to a 63-year old woman scheduled for extracorporeal shock wave lithotripsy. She requests sedation.

1. What is your choice? Explain.

2. After she is in the water bath, you administer 2.5 mg intravenous midazolam and she becomes unresponsive and cyanotic. What is the probable cause?

3. What is your management?

Submandibular abscess

A 50-year old woman presents for urgent drainage of a submandibular abscess.

1. What are the anesthetic considerations in this case?

2. How will you evaluate his airway?

3. Is awake intubation indicated? Explain.