TYK259

Children with TBI often have altered cerebral hemodynamics. These patients may present following unintentional trauma or as victims of intentional trauma. They may require anesthesia for neurosurgical procedures immediately after presentation. Which of the following statements is INCORRECT?

a) Increased CMRO2 caused by seizures may be controlled with muscle paralysis

b) Cerebral perfusion may be best maintained by ensuring a CPP of at least 40 mmHg

c) Narcotic use should be avoided if mechanical ventilation is not anticipated

d) Sustained ICP above 20 mmHg is associated with poor outcomes

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Answer

Answer a. Muscle paralysis will stop the physical appearance of a convulsion but will not terminate seizure activity of the brain, and therefore should never be used to treat a seizure. When intubation is required for airway protection and neuromuscular blockade is necessary, an adequate amount of anti-epileptic drug should be first administered to ensure ongoing occult seizure activity does not occur.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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