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80kg, 70yo woman is scheduled for a mastectomy. Has hx of CHF tx w/ digoxin 0.25mg qd. preop exam shows NSR at 80 bpm & BP of 110/70. K is 4.2 and digoxin is 1.5ug/ml. Five minutes after induction of GA, ventricular bigeminy is noted; bp is 85/65, spo2 is 97% & etco2 is 20mmHg
What's most appropriate managment?
a) CaCl
b)ephedrine
c)lidocaine
d)KCL
e)decrease ventilation
According to the key the answer is (e). I chose (c). My reasoning was that if I control the ventricular bigeminy the bp will rise and so with it will the etco2. I couldn't find much in the textbooks regarding a scenario like this. Obviously hypocapnia is the key to the answer; can anyone explain why?
What's most appropriate managment?
a) CaCl
b)ephedrine
c)lidocaine
d)KCL
e)decrease ventilation
According to the key the answer is (e). I chose (c). My reasoning was that if I control the ventricular bigeminy the bp will rise and so with it will the etco2. I couldn't find much in the textbooks regarding a scenario like this. Obviously hypocapnia is the key to the answer; can anyone explain why?