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Oral case 20

Created: 16/2/2006

Obstetrical Anesthesia- Regional Anesthesia in a Febrile patient

A 22-year old woman is scheduled for a cesarean section for premature rupture of the membranes. Blood pressure is 110/60 mm Hg, pulse is 110, and temperature is 38.5 degrees centigrade. She requests regional anesthesia.

1. What is your response?

2. You do a subarachnoid block, and two days later she had a severe headache and continues to have a low-grade fever. How would you evaluate her now?

3. How do you manage post-spinal headache?

Management of chronic pain: A 55-year old male with pancreatic cancer is referred to you for treatment of severe abdominal and back pain.

1. What is your evaluation of this patient?

2. How would you manage this patient?

3. What drug would you use to block the celiac plexus?

Narcotic antagonists

1. What narcotic-related side effects can be reversed with naloxone?

2. What side effects may occur after naloxone therapy for narcotic-induced respiratory depression?

3. How can you avoid these problems?

4. Are there any other agents effective in reversing narcotics?

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