Wed3November0832PM 5

Regarding the management of pre-eclampsia prior to a category 2 caesarean section, which of the following statements is/are true and which false?

True / False

Magnesium sulphate infusion is the first line of treatment to control hypertension Correct

Labetalol can be used to control blood pressure Correct

Neuraxial block is the most appropriate technique of anaesthesia for caesarean section Incorrect answer selected

Nifedipine orally may be safely used Correct

Remifentanil may be used to obtund the hypertensive response to intubation if general anaesthesia is chosen for surgery Correct

Explanation

Pre-eclampsia is characterised by elevated blood pressure and involvement of one or more organ systems. Patients may suffer from severe headache or epigastric pain. Symptoms may resolve within three months after delivery.

It is recommended to decrease the blood pressure to a systolic level of 140-150 mmHg and a diastolic of 90-100 mmHg.

For severe hypertension (systolic = 160 mmHg; diastolic = 110 mmHg), it is recommended to use oral or intravenous labetalol. Oral nifedipine and intravenous hydralazine are alternatives for blood pressure control.

Seizures are a life threatening complication of pre-eclampsia. Magnesium sulphate is the drug of choice in the presence of seizures.

Neuraxial anaesthesia is the preferred method for a caesarean section delivery. If general anaesthesia is administered to pre-eclamptic women, opioids such as remifentanil, alfentanil, or fentanyl can be used to obtund the pressor effects of laryngoscopy and endotracheal intubation.

Reference:

Medscacpe. Anesthesiologists' Role in Treating Preeclampsia.

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Average score: 74.36%

Times answered: 298