Episode 229 — Keywords Part 19 — Epidurals
Highlights
- The earliest signs are going to be the least Concerning Things
Summary:
A 75 year old female with ovarian cancer is scheduled for a total abdominal historectime bilateral salpingo oo parrectim and tumor debulking. Thorastic epidoral anaesthesia was performed. A test dose of one point five % lidicane with one to 200 thousand epineferin is injected through the epiderala catheder. 30 seconds later, the patient became agitated and complained of light headedness, tenitus and feeling faint. The most likely diagnosis is a local anaesthetic toxicity. B, high epideral anecesa. C, total spinal anecesia. D, an phlactic reaction.
Transcript:
Speaker 2
mouths. So
Speaker 1
te se is going t be the answer. Eri is beasicly like the de like, less concerning symptom. Rig once you get to e, nicenice agnes and seepictifly in the way, more concerning area. So the earliest signs are going to be the least concerning things. Write next question. So a 75 year old female with ovarian cancer is scheduled for a total abdominal historectime bilateral salpingo oo parrectim and tumor debulking. Thorastic epidoral anaesthesia was performed. And a test dose of one point five % lidicane with one to 200 thousand epineferin is injected through the epiderala catheder. That resulted in no evidence of adversiy im the catheder. Ye. The cathe is threaded and no negative spiration. Everything les good. And then the gave ten amel of half % bupivicane through the epideral. 30 seconds later, the patient became agitated and complained of light headedness, tenitus and feeling faint. But is still able to move all her extremities. Her blood pressure decreased from one 50 over 70 to 100 over forty five. And her heart rate decreased from 85 to 55. The patient maintains spontaneous breathing throughout with an oxygen saturation of 95 % on room air. The most likely diagnosis is a local anaesthetic toxicity. B, high epideral anecesa. C, total spinal anecesia. D, an phlactic reaction.
Speaker 3
So you may be tempted to say, you know, either high epidoral or high spinal. But, you know, she can move all her extremities, so that doesn't mix sense. So
Speaker 2
it exabaly last, it's probably local. I isthis little final
Speaker 1
she wouldn't be breathing on her own. Lake broy would have lake apne at, right? And if it was high epidoral, you would expect with point five ant bupivicant, like motor and sensory deficits. So you don't have that. And aniflaxis jus doesn't really, like, fit into the picture here. So it is last. And reading up, like, the explanation that this person wrote is that last is probably very under (Time 0:31:08)
Episode 229 — Keywords Part 19 — Epidurals
Highlights
- The earliest signs are going to be the least Concerning Things
Summary:
A 75 year old female with ovarian cancer is scheduled for a total abdominal historectime bilateral salpingo oo parrectim and tumor debulking. Thorastic epidoral anaesthesia was performed. A test dose of one point five % lidicane with one to 200 thousand epineferin is injected through the epiderala catheder. 30 seconds later, the patient became agitated and complained of light headedness, tenitus and feeling faint. The most likely diagnosis is a local anaesthetic toxicity. B, high epideral anecesa. C, total spinal anecesia. D, an phlactic reaction.
Transcript:
Speaker 2
mouths. So
Speaker 1
te se is going t be the answer. Eri is beasicly like the de like, less concerning symptom. Rig once you get to e, nicenice agnes and seepictifly in the way, more concerning area. So the earliest signs are going to be the least concerning things. Write next question. So a 75 year old female with ovarian cancer is scheduled for a total abdominal historectime bilateral salpingo oo parrectim and tumor debulking. Thorastic epidoral anaesthesia was performed. And a test dose of one point five % lidicane with one to 200 thousand epineferin is injected through the epiderala catheder. That resulted in no evidence of adversiy im the catheder. Ye. The cathe is threaded and no negative spiration. Everything les good. And then the gave ten amel of half % bupivicane through the epideral. 30 seconds later, the patient became agitated and complained of light headedness, tenitus and feeling faint. But is still able to move all her extremities. Her blood pressure decreased from one 50 over 70 to 100 over forty five. And her heart rate decreased from 85 to 55. The patient maintains spontaneous breathing throughout with an oxygen saturation of 95 % on room air. The most likely diagnosis is a local anaesthetic toxicity. B, high epideral anecesa. C, total spinal anecesia. D, an phlactic reaction.
Speaker 3
So you may be tempted to say, you know, either high epidoral or high spinal. But, you know, she can move all her extremities, so that doesn't mix sense. So
Speaker 2
it exabaly last, it's probably local. I isthis little final
Speaker 1
she wouldn't be breathing on her own. Lake broy would have lake apne at, right? And if it was high epidoral, you would expect with point five ant bupivicant, like motor and sensory deficits. So you don't have that. And aniflaxis jus doesn't really, like, fit into the picture here. So it is last. And reading up, like, the explanation that this person wrote is that last is probably very under (Time 0:31:08)