Obstetric anaesthesia: pre-eclampsia and laryngoscopy: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Obstetric anaesthesia: pre-eclampsia and laryngoscopy

Sample item

A woman with severe pre-eclampsia requires general anaesthesia for an emergency caesarean section. Which drug attenuates the pressor response to laryngoscopy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Remifentanil or alfentanil given with induction

Laryngoscopy and intubation cause severe hypertension that can precipitate intracerebral haemorrhage in severe pre-eclampsia. A short-acting opioid such as remifentanil or alfentanil, or lignocaine or magnesium, blunts this response. Neonatal respiratory depression is anticipated and managed by the paediatric team.

Option by option

  • A. Ephedrine

    Ephedrine is a vasopressor and would worsen hypertension.

  • B. Ergometrine

    Ergometrine causes vasoconstriction and is contraindicated in hypertension.

  • C. Ketamine as the sole induction agent

    Ketamine causes hypertension and tachycardia and is undesirable here.

  • D. Remifentanil or alfentanil given with induction (correct)

    Correct. A potent short-acting opioid blunts the pressor response.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Remifentanil or alfentanil given with induction. Laryngoscopy and intubation cause severe hypertension that can precipitate intracerebral haemorrhage in severe pre-eclampsia.

Why is "Ephedrine" not the answer?

Ephedrine is a vasopressor and would worsen hypertension.

Why is "Ergometrine" not the answer?

Ergometrine causes vasoconstriction and is contraindicated in hypertension.

Why is "Ketamine as the sole induction agent" not the answer?

Ketamine causes hypertension and tachycardia and is undesirable here.

What concept does this question test?

It tests Obstetric anaesthesia: pre-eclampsia and laryngoscopy in Anaesthesia. A short-acting opioid such as remifentanil or alfentanil, or lignocaine or magnesium, blunts this response. Neonatal respiratory depression is anticipated and managed by the paediatric team.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric anaesthesia: pre-eclampsia and laryngoscopy?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.