Abdurahman Hafsa Warsame, Aidid Nusaipa Mubarak

Clinical case # 1_a

A 79 years old man goes for a transurethral resection of prostate because of prostate
hypertrophy. Six years ago the patient had myocardial infarction. Since then no heart pain or
other heart problems. He is receiving Digoxin (0.25 mg/day). Allergy to Novocain (Procaine).
Physical examination reveals limited mobility of vertebral column, especially at lumbar level.

QUESTIONS

1. Evaluate the physical status of the patient by ASA scale

2. Anesthesia technique most appropriate for this patient?
3. Contraindications for this anesthesia technique
4. Special preparation for this type of anesthesia

Ali-Heybe Hafsa Ahmed, Cimen Zeynep Beyza Erol

Clinical case # 1_b

A 79 years old man goes for a transurethral resection of prostate because of prostate
hypertrophy. Six years ago the patient had myocardial infarction. Since then no heart pain or
other heart problems. He is receiving Digoxin (0.25 mg/day). Allergy to Novocain (Procaine).
Physical examination reveals limited mobility of vertebral column, especially at lumbar level.

QUESTIONS
1. Can regional anesthesia be applied to this patient taking into account allergy to Novocain?
2. What additional equipment should be ready to be used during spinal anesthesia?
3. Spinal anesthesia technique
4. Medicines used for spinal anesthesia

Gure Hajara Abdullahi Bile, Gure Maryama Abdullahi Bile

Clinical case # 1_c

A 79 years old man goes for a transurethral resection of prostate because of prostate
hypertrophy. Six years ago the patient had myocardial infarction. Since then no heart pain or
other heart problems. He is receiving Digoxin (0.25 mg/day). Allergy to Novocain (Procaine).
Physical examination reveals limited mobility of vertebral column, especially at lumbar level.

QUESTIONS

1. Epidural anesthesia technique

2. Medications used for epidural anesthesia
3. Advantages of spinal anesthesia versus epidural anesthesia in this patient
4. Complications of spinal and epidural anesthesia
Întuneric Simina Adrian, Ismail Ayaan mukhtar abdi Mukhtar abdi ismail

Clinical case # 1_d

A 79 years old man goes for a transurethral resection of prostate because of prostate
hypertrophy. Six years ago the patient had myocardial infarction. Since then no heart pain or
other heart problems. He is receiving Digoxin (0.25 mg/day). Allergy to Novocain (Procaine).
Physical examination reveals limited mobility of vertebral column, especially at lumbar level.

QUESTIONS
1. Factors influencing movement of the anesthetic in the cerebrospinal fluid
2. Advantages of adding vasopressors to the local anesthetic solution
3. Advantages of spinal anesthesia versus general anesthesia
4. Other anesthesia techniques can be applied in this patient

Mohamed Faahiye Salad Mohamed Filsan Mahamed, Mohamed Ismail Hafsa Mohamed Ismail

Clinical case # 2

A 75 years old man was admitted to ICU after kidney stone surgery. Medical history:
Myocardial infarction with compensated congested heart failure. During surgery he received
3 Liters of iv fluids, including 500 ml of HES (Hydroxyethyl Starch). On the admission was
diagnosed pulmonary edema.

QUESTIONS

1. Evaluate physical status of the patient by ASA scale

2. Anesthesia techniques appropriate for this patient
3. Potential causes of pulmonary edema
4. Diagnosis and treatment

Mohamed ismail Shucayb Ismail shucayb, Riam Safaa Nisaf Al-Amary

Clinical case # 3
A 35 years old patient was admitted to ICU with multiple rib fractures, acute respiratory failure
and right sided open multiple femoral fractures with continuing small blood loss. Blood pressure
– 90/60 mmHg, Heart rate – 110 / min.

QUESTIONS

1. Evaluate physical status of the patient by ASA scale

2. Anesthesia techniques appropriate for this patient
3. List main focuses for the preoperative preparation in this patient