Anaes Vivas · Acute pain & multimodal analgesia
Acute pain & multimodal analgesia — Viva
Clinical viva on the foundations-first multimodal plan, PCA safety, and the LAST/ASRA pathways
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Prompt
Post-colectomy PCA chart with overnight bolus increases and no functional gain
Viva Stems
- This PCA chart shows overnight bolus increases with no functional gain. What is the diagnosis and the plan?
- Talk me through the multimodal foundations and their taught doses.
- What are the PCA safety rules?
- When would you use an epidural here, and what governs anticoagulation timing?
- What are the red flags on an epidural, and what do you do?
- Talk me through LAST prevention, recognition, and treatment.
- The patient is opioid-tolerant. How does the plan change?
- What are the common exam pitfalls in this topic?
References2ShowHide
- [1]Neal JM et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017 Reg Anesth Pain Med, 2018.PMID 29356773
- [2]Horlocker TT et al. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) Reg Anesth Pain Med, 2018.PMID 29561531