Anesthesia Pharmacology:  General Anesthesia Clinical Case Questions

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  • A 45 year-old man was admitted to the same day surgery for repair of a direct inguinal hernia. A spinal anesthetic was administered, which was of sufficient level and duration to encompass the analgesic requirement for surgery.

  •  After the spinal was given and surgery started, the anesthetist asked the patient if he wished to be sedated.

  •  At first he refused, but as the procedure progressed he began to feel visceral traction as the hernia sac was opened.

  •  There was no somatic pain, but the abdominal irritation led the patient to ask for a sleep-producing medication.


  • case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
    case editor: Michael Gordon, Ph.D.