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Oral case 22

Created: 16/2/2006

Spinal anesthesia- complications

Four days after a subarachnoid block for arthroscopy of the right knee as an outpatient, the patient calls to say he has numbness in the lateral right knee and right buttock. He also has back pain, headache, and nausea.

1. What is your differential diagnosis?

2. How would you evaluate and then confirm your diagnosis?

3. Would the differential diagnosis be different if epidural anesthesia had been used? Explain.

Trace anesthetics

During the past year, five operating room nurses had spontaneous abortions and two had infants with skeletal deformities. You are asked to give a nursing conference about the risks of trace anesthetics.

1. What would you say?

Emergency surgery- thyrotoxicosis

A 30-year old woman with untreated thyrotoxicosis requires surgery for ruptured appendix. Blood pressure is 180/90 mm Hg, pulse is 120 bpm, and temperature is 38 degrees centigrade.

1. Is regional anesthesia safer than general anesthesia for this patient? Explain.

2. Would you pretreat this patient with anything in order to minimize risks?

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