A 20 kg child scheduled for elective herniotomy requires intraoperative maintenance fluid therapy using the Holliday-Segar (4-2-1) formula. The appropriate maintenance fluid rate is:

• A 40 mL/hr
• B 50 mL/hr
• C 60 mL/hr ✓
• D 80 mL/hr

Explanation

The 4-2-1 rule gives 4 mL/kg/hr for the first 10 kg (40 mL/hr) plus 2 mL/kg/hr for the second 10 kg (20 mL/hr), totalling 60 mL/hr. Option A applies only the 4 mL/kg component and ignores the second weight band, while option D incorrectly uses 4 mL/kg/hr across all 20 kg. This formula is standard in paediatric anaesthesia texts and is repeatedly examined.

Reference: Smith's Anesthesia for Infants and Children, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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