A test on:

Epidural Misadventures
A review of the risk and complications associated with
epidural anaesthesia

by Holly A. Muir, MD, FRCPC
Set up to demonstrate ExamMail by Dr John Oyston & Carsten Schafer
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Question 1

Which type of anaesthetic has the higher risk of death in a pregnant patient?
[](a)General anaesthesia
[](b)Regional anaesthesia
[](c)Don't know

Question 2

According to the Closed Claim Study, which type of anaesthetic has the higher risk of nerve injury in a pregnant patient?
[](a)General anaesthesia
[](b)Regional anaesthesia
[](c)Don't know

Question 3

The incidence of neurological complications related to obstetrical delivery (without epidural anaesthesia) is:
[](a) 1:10 or higher
[](b) 1:100 - 1:1,000
[](c) 1:2,000 - 1:6,400
[](d) 1:10,000 - 1:17,500
[](e) 1:10,0000 - 1:17,5000
[](f) Don't Know

Question 4

The incidence of epidural abscesses in patients with epidurals is:
[](a) 2:10,000
[](b) 1:20,000
[](c) 1:505,000
[](d) 1:1,050,00
[](e) Don't Know

Question 5

According to Chadwick, an anesthesiologist is more likely to be involved in a suite related to a minor injury.
[](a) True
[](b) False
[](c) Don't Know

FOR THE NEXT FOUR QUESTIONS, ANSWER

Question 6

Which injuries are less common in obstetrical malpractice claims, compared to non-obstetric claims?
  1. Death
  2. Brain Damage
  3. Nerve Injury
  4. Headache
  5. Back Pain
Answer:
[](a) if 1,2 and 3 are correct
[](b) if 2 and 4 are correct
[](c) if 1 and 3 are correct
[](d) if all are correct
[](e) Don't Know

Question 7

In obstetric patients, which complaints are more common after regional anaesthesia than after general?
  1. Headache
  2. Pain during anaesthesia
  3. Back Pain
  4. Neonatal brain damage
  5. Patient Death
Answer:
[](a) if 1,2 and 3 are correct
[](b) if 2 and 4 are correct
[](c) if 1 and 3 are correct
[](d) if all are correct
[](e) Don't Know

Question 8

The lithotomy position may be associated with damage to the following nerves:
  1. Femoral Nerve
  2. Lat cutaneous nerve
  3. Sciatic nerve
  4. Obturator nerve
  5. Common peroneal nerve
Answer:
[](a) if 1,2 and 3 are correct
[](b) if 2 and 4 are correct
[](c) if 1 and 3 are correct
[](d) if all are correct
[](e) Don't Know

Question 9

Which statements about the spinal cord are true?
  1. Pain on injection during an epidural is of no consequence
  2. In 90% of adults the cord ends above the level of the second lumbar vertebra
  3. Nerve root trauma has been reported in 7% of patients after epidural anaesthesia
  4. In 10% of adults the cord extends to the third lumbar vertebra
  5. Direct trauma to the spinal cord during epidural anaesthesia is common.
Answer:
[](a) if 1,2 and 3 are correct
[](b) if 2 and 4 are correct
[](c) if 1 and 3 are correct
[](d) if all are correct
[](e) Don't Know

Question 10

Vandermuelen studied 46 cases of spinal-epidural haematoma associated with epidural anaesthesia. What were the risk factors in this group?
  1. Half were on anticoagulants
  2. Four had thrombocytopenia
  3. Nineteen had no risk factors
  4. All were pregnant
Answer:
[](a) if 1,2 and 3 are correct
[](b) if 2 and 4 are correct
[](c) if 1 and 3 are correct
[](d) if all are correct
[](e) Don't Know

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©Dr John Oyston, 1996.
Printed copies can be made for non-profit educational use.
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1-Jan-97 Revised 6-Mar-97
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