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Oral case 18

Created: 16/2/2006

Regional anesthesia- intravenous block

1. How do lower and upper extremity intravenous blocks differ?

2. Describe the management of lower versus upper extremity blocks.

3. Describe complications and their management.

Anesthesia during pregnancy: a patient has acute appendicitis

1. What are your anesthetic considerations?

2. How do your concerns relate to the duration of the pregnancy?

3. Are there any drugs to avoid? Explain.

4. What would be your technique of choice, and why?

Significance of geriatric status to anesthesia

1. How do the elderly differ from the young, regarding anesthesia?

The elderly have an increased total volume of distribution, and decreased elimination, resulting in longer-lasting effects. Dose reductions of intravenous agents may have to be reduced, and should be based on lean body mass.

2. Discuss changes in MAC.

The MAC is the minimum alveolar concentration required at sea level, to prevent 50% of patients from moving upon surgical stimulation. It is the highest in infants from birth to six months of age, and decreases with age.

3. What factors decrease MAC?

Hypothermia, opioids, barbiturates, calcium-channel blockers, and pregnancy.

4. Name factors, which do not change MAC.

Thyroid function, hypocarbia, hypercarbia, and hyperkalemia.

3. Discuss changes in drug disposition.

4. Discuss changes in organ system functions.

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