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Oral case 24

Created: 6/9/2004


A 4 kg neonate in the intensive care unit presents for repair of diaphragmatic hernia.

1. How will you induce anesthesia?

2. Compare and contrast awake versus anesthetized intubation.

3. After the hernia is reduced, the patient becomes hypotensive and has poor pulmonary compliance. What is the cause?

4. What is your management?

5. Would you ventilate this patient mechanically postoperatively? Why or why not?


Equipment problem

Shortly after intubating a healthy patient for a hysterectomy, you add 50% nitrous oxide to an isoflurane/oxygen anesthetic. The pulse oximeter shows a drop in oxygen saturation from 100 % to 85%.

1. What is your differential diagnosis?

2. What is your management?

3. Describe steps in arriving at a diagnosis.

Postoperative hoarseness

A patient whom you intubated for a carotid endarterectomy is still hoarse five days postoperatively.

1. What are possible causes?

2. How would you evaluate this patient?

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