March 2013

a) What are the indications for ‘one lung ventilation’ (OLV)? (30%)

b) How can the risks associated with lung resection be quantified preoperatively? (30%) c) How would you manage the development of hypoxaemia during OLV? (40%)
88.6% pass rate.

This area has been covered in previous SAQ exams (2006 and 2009), and was a very straightforward test of knowledge. Significant numbers of candidates scored 16/20 or more.
September 2012

a) List the indications for endoscopic thoracic sympathectomy (ETS). (25%)

b) Outline the general (30%) and airway (15%) implications of managing a patient for ETS under general anaesthesia.

c) What are the most likely problems to be encountered in the intraoperative (15%)

d) and postoperative (15%) period?
Question 4: Endoscopic transthoracic sympathectomy.

26.5% pass rate.

This question was universally answered badly. Clearly most candidates had never anaesthetized a patient for the procedure nor had any knowledge about the procedure despite being part of the syllabus. Knowledge of the effects of one-lung anaesthesia, effects of a capnothorax and indications for a sympathectomy were relevant in the answer. The pass mark had been adjusted to reflect the level of difficulty (“hard”).

These ten key facts would have been sufficient for a pass (there were 23 in the model answer).
a) Indications for transthoracic sympathectomy
Hyperhidrosis
Chronic pain/upper limb regional pain syndrome

b) General Implications
Large bore IV access
Potential for major haemorrhage May need arterial line
Airway implications
May need double lumen tube

c) Intraoperative problems Hypotension from capnothorax
Hypoxia Postoperative problems
May have residual pneumothorax
May be painful

The mean score was 7.7/20. The question was a strong discriminator.
Whilst the question appeared difficult most of the answer required a systematic approach.
September 2009

a) List the indications for placement of a double lumen tube in anaesthesia and critical care. (25%)

b) List, giving appropriate threshold values for each, the methods of pre-operative respiratory assessment you would use in an adult to decide whether a patient could tolerate lung resection. (25%)

c) How would you manage the development of hypoxaemia during one-lung anaesthesia? (40%)
Question11 Critical care/management of airway problem/tracheostomy

76.6% pass rate

In the main was a well-answered question
May 2006

a) What are the indications for “one lung anaesthesia”? (30%)
b) List the methods of pre-operative assessment you would use to decide whether an adult could tolerate “one lung anaesthesia”. (30%)
c) How could you manage the development of hypoxaemia during “one lung anaesthesia”? (40%)
Question11 Critical care/management of airway problem/tracheostomy

76.6% pass rate

In the main was a well-answered question
October 2005

What tests of lung function can be used to predict whether a patient will tolerate a pulmonary resection ? (60%)

Indicate minimum values for lobectomy and pneumonectomy. (40%)
Question11 Critical care/management of airway problem/tracheostomy

76.6% pass rate

In the main was a well-answered question
May 2004

Describe the pre-operative assessment and preparation specific to an adult patient who requires a thoraco-abdominal oesophagectomy?
Describe your anaesthetic plan for this operation.
Question11 Critical care/management of airway problem/tracheostomy

76.6% pass rate

In the main was a well-answered question