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744 Anaesthesia

A previously healthy 55-year-old man undergoes elective right hemicolectomy for a stage I (T2N0M0) cancer of the cecum. His postoperative ileus is somewhat prolonged, and on the fifth postoperative day his nasogastric tube is still in place. Physical examination reveals diminished skin turgor, dry mucous membranes, and ohostatic hypotension. Peinent laboratory values are as follows: Aerial blood gases: pH 7.56, PCO2 50 mm Hg, PO2 85 mm Hg. Serum electrolytes (mEq/L): Na + 132, K+ 3.1, Cl – 80; HCO3 – 42. Urine electrolytes (mEq/L): Na + 2, K+ 5, Cl – 6. What is the patient’s acid-base abnormality?

AUncompensated metabolic alkalosis
BRespiratory acidosis with metabolic compensation
CCombined metabolic and respiratory alkalosis
DMetabolic alkalosis with respiratory compensation
Anaesthesia
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746 Anaesthesia

All the following statements about Epinephrine used as an adjuvant are true Except

AExtends block duration, limits systemic uptake, supplements analgesic effect, and acts as an indicator of intravascular injection
BCan cause toxicity to peripheral nerves in patients with diabetes or chemotherapy
CLocal anaesthetics and epinephrine have no effect on peripheral nerve blood flow
DCan aggravate local anaesthetic-induced neuraxial or peripheral nerve injury
Anaesthesia
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