Episode 13: Ask an Intelligent Question - Get a Mediocre Answer!

Episode Summary

In this episode of the APEX Live Anesthesia Podcast, we answer several clinical questions submitted by our listeners. The topics range from using ondansetron to treat hypotension from neuraxial anesthesia to using a cephalosporin in a patient with a penicillin allergy. Buckle up… you’re not going to want to miss the mediocre madness!


What You'll Learn

  • Can ondansetron, either prophylactically or acutely, decrease the degree of hypotension after neuraxial anesthesia?
  • What is A-OK treatment in a patient who experiences an amniotic fluid embolism?
  • Can I administer ketorolac to someone who is at risk for bleeding?
  • If a patient has an allergy to penicillin, can I give them cefazolin?


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Recommended Resources

  1. Gobble RM, et al. Ketorolac does not increase perioperative bleeding: a meta-analysis of randomized controlled trials. Plastic and Reconstructive Surgery. 2014; 133(3): 741-755.
  2. Singer AJ, et al. The effect of IM ketorolac tromethamine on bleeding time: A prospective, interventional, controlled study. Am J Emerg Med. 2003;21:441–443.
  3. Strom BL, et al. Parenteral ketorolac and risk of gastrointestinal and operative site bleeding: A postmarketing surveillance study. JAMA. 1996;275: 376–382.
  4. Beltran RJ, et al. Penicillin allergy and surgical prophylaxis: cephalosporin cross-reactivity risk in a pediatric tertiary care center. J Pediatr Surg. 2015;50:856–859.
  5. Macy E., et al. Adverse reactions associated with oral and parenteral use of cephalosporins: A retrospective population-based analysis. J Allergy Clin Immunol. 2015 Mar;135(3):745-52.e5.
  6. Jeffres M, et al. Systematic Review of Professional Liability when Prescribing Β-Lactams for Patients with a Known Penicillin Allergy. Open Forum Infect Dis. 2017;4(Suppl 1):S341.
  7. Zagursky RJ, et al. Cross-reactivity in β-lactam allergy. J Allergy Clin Immunol Pract. 2018;6:72–81.e1.
  8. Gao L, et al. Effects of prophylactic ondansetron on spinal anesthesia-induced hypotension: a meta-analysis. International Journal of Obstetric Anesthesia. 2015:24(4);335-343.
  9. Rezai S. et al. Atypical amniotic fluid embolism managed with a novel therapeutic regimen. Case Reports in Obstetrics and Gynecology. 2017, Article ID 8458375.


Legal Disclaimer

APEX Anesthesia Review, LLC and APEX Live expressly disclaim any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Podcast music by Eino Toivanen, kongano.com


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