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Oral case 12

Created: 6/9/2004

Reversal of narcotics-pharmacology of naloxone

The recovery room nurse says another anesthesiologist uses an infusion of naloxone to reverse morphine depression.

2. Is this reasonable? Why or why not?

3. Do you prefer to administer intermittent doses? Why?

Blood patch for post-spinal headaches

Cerebrospinal fluid return occurs with attempted epidural placement.

1. What immediate steps do you take?

2. The patient complains of headache. What is your management?

3. Describe indications and complications of the epidural blood patch.

Cardiac pacemakers and anesthesia

1. Does their presence affect your choice of anesthesia for hernia repair? Why or why not?

2. How does it alter your management?

3. Describe the different types of pacemakers.

4. What are the indicators of pacemaker failure?

Mechanics of breathing-high frequency ventilation

Since such high peak end-expiratory pressures seem necessary in your patient with Adult Respiratory Distress Syndrome, your colleague suggests high frequency ventilation.

1. Do you agree? Why or why not?

2. How does jet ventilation work?

3. What are some reported advantages of jet ventilation?

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