Mock oral exams › Repeat cesarean delivery in a parturient taking buprenorphine for opioid use disorder
Full access · Session 2: short stem · 13 questions · 35 min
Repeat cesarean delivery in a parturient taking buprenorphine for opioid use disorder
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The stem
A 31-year-old woman, G3P2 at 39 weeks, 88 kg and 165 cm, is scheduled for elective repeat cesarean delivery. She has opioid use disorder in remission for three years and takes sublingual buprenorphine-naloxone 8 mg/2 mg three times daily. Her last cesarean, under general anesthesia for a failed epidural, was "the worst pain of my life," and she is afraid she will be "cut off" again. She smokes half a pack a day and has untreated hepatitis C with normal liver enzymes. She has no allergies.
- Blood pressure 118/72, heart rate 84, SpO2 98% on room air
- Airway: Mallampati 2, full neck extension
- Hemoglobin 11.6 g/dL, platelets 214,000/µL, INR 1.0
- Placenta posterior and fundal on ultrasound; estimated fetal weight 3,400 g