Flashcards in Week 1 Maternal and Fetal Phy 3 of 4 Deck (76)
Mag sulfate increases the sensitivity to both depolorizing and non depolorizing muscle relaxants, thus will you increase or decrease the dose of muscle relaxant?
decrease the dose of muscle relaxant.
What can lidocaine cause in high doses to the pregnant patient.
in high doses can cause uterine vasoconstriction and increased tone.
What PH of the fetus will cause MORE ion trapping of LA?
the lower the fetal PH the more ion trapping.
All LA that we use in an IV or injected form (not topical) are what PH?
Higher PH, they are bases
What is the issue if the mom has alkalosis and the baby has acidosis?
because LA are bases the mothers alkalosis promotes un-ionized drug (LA) and thus can cross the placenta very easily, but once it crosses the placenta the babies acidosis promotes ion trapping.
Base + acid = ?
base + acid = ionized (can not cross, trapped in fetus)
Base + base = ?
un-ionized (can cross)
Pregnant patients are always considered full stomach True or False?
True, they are high risk for aspiration
What two drugs can you give a full stomach mom?
H2 blockers and metoclopramide
What are two morbidities associated with Mother/Child?
When trying to give pain management to a pregnant patient, are opioids or regionals preferred and why?
Regional preferred bc opioids cross placental barrier.
Mother/child issues with lumbar epidural?
what will you give to treat?
hypotension, give ephedrine and IV fluids.
Problems with GA and a pregnant patient?
Rapid desaturation, laryngeal spasm/edema, aspiration.
Since you do not want to use GA for pregnant patient if you can help it, what type of anesthesia would you prefer to use for C/S?
spinal epidural anesthesia/ analgesia
Level of the block for a C/S?