Question 4

A 58-year-old obese woman is scheduled for laparoscopic cholecystectomy. Her current medication includes: carbamezepine, omeprazole and gaviscon (as needed). Which of the following plans for neuromuscular blockade is most appropriate in this case?

Select one option from the answers below, then select Submit.

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Option C is the best choice.

Many obese patients have problems with reflux. This patient is on omeprazole and gaviscon, suggesting persistent and troublesome reflux. Therefore, in this case there are two good reasons for performing a RSI. This excludes options B and D.

She is taking carbamezepine, which shortens the duration of neuromuscular blockade with vecuronium, so adequate relaxation would require large doses. Therefore, it is better to avoid vecuronium. This excludes option A.

Succinylcholine should not be used for maintaining paralysis, although it is a good choice for RSI. This excludes option E.

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