drdiv
Forum Junior
Topics: 16
Posts: 63
|
which of the following mat condition is a contraindication for epidural anaesthesia?
a,hypertension
b,chronic anaemia
c,plateletcount <400,000
d,mitral stenosis
e,previous c.section
|
| mazinger
Forum Guru
Topics: 46
Posts: 918
|
Mitral stenosis
These patients have a sympathetic blockade (below the site of the application) which will decrase the venous return (preload and stroke volume are obviously decreased) and in a patient with valve stenosis (more importantly aortic) this effect may have detrimental effects like death.
Chronic anemia is not an absolute contraindication, it will depend on the status of the patient. I guess you can not give an epidural to an elderly patient with CAD and an hematocrit of 28%. But perhaps you can give it to a relatively young woman with an hematocrit of 35%.
So this depends mainly on the status of the patient and any asociated morbidities..
___________________
original mazinger z
|
| frank100
Forum Guru
Topics: 48
Posts: 586
|
a) if it is systemic hypertension is relative because you can lower it by giving medication previously, if this is CNS Hypertensionyou shouldn´t do that.
b) chronic anemia: not really a contraindication.
c) ptls < 400.000, can be normal until you get to 100.000, so tha option is kinda weird...
d) mitral stenosis: not really a con, but cardiac heart valve problems are a contraindication to LP. ony if they are causing problems right now...
e) prvious c section is not a con
the question gives no clue at all of what the answer can be, or what they want you to answer, but in despite of no clues (d), seems a good answer...
the rest of the options can be contraindications too, but it depends of the case they´re giving to you.
|
| drdiv
Forum Junior
Topics: 16
Posts: 63
|
hi mazinger
but in kap lecture notes it is given like epidural can be given in ms patients to decrease strain
|
| mazinger
Forum Guru
Topics: 46
Posts: 918
|
what you say makes sense... I guess I was wrong... hahaha 
___________________
original mazinger z
|
|
| |
| | | | | |
