Intravenous agents: thiopentone intra-arterial injection: 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 · Intravenous agents: thiopentone intra-arterial injection

Sample item

Thiopentone is accidentally injected into the radial artery and the patient complains of severe burning pain with a blanched hand. What is the appropriate management?

AGive a vasoconstrictorBApply a tourniquet proximal to the siteCLeave the cannula in place, give saline flush, papaverine or lignocaine and consider heparin and brachial plexus blockDRemove the cannula and apply a tight bandage

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

The answer and the reasoning

C. Leave the cannula in place, give saline flush, papaverine or lignocaine and consider heparin and brachial plexus block

Thiopentone forms crystals in the arterial blood at pH 10.5 and causes intense vasospasm and thrombosis. The cannula is left in situ to dilute the drug, and vasodilators, local anaesthetic, heparin and sympathetic block are used.

Option by option

A. Give a vasoconstrictor
Vasoconstrictors would worsen ischaemia.
B. Apply a tourniquet proximal to the site
A tourniquet worsens ischaemia.
C. Leave the cannula in place, give saline flush, papaverine or lignocaine and consider heparin and brachial plexus block (correct)
Correct. Dilute, dilate and anticoagulate.
D. Remove the cannula and apply a tight bandage
Removing the cannula loses access for treatment.

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.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Leave the cannula in place, give saline flush, papaverine or lignocaine and consider heparin and brachial plexus block. Thiopentone forms crystals in the arterial blood at pH 10.

Why is "Give a vasoconstrictor" not the answer?

Vasoconstrictors would worsen ischaemia.

Why is "Apply a tourniquet proximal to the site" not the answer?

A tourniquet worsens ischaemia.

Why is "Remove the cannula and apply a tight bandage" not the answer?

Removing the cannula loses access for treatment.

What concept does this question test?

It tests Intravenous agents: thiopentone intra-arterial injection in Anaesthesia. 5 and causes intense vasospasm and thrombosis. The cannula is left in situ to dilute the drug, and vasodilators, local anaesthetic, heparin and sympathetic block are used.

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 Intravenous agents: thiopentone intra-arterial injection?

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.