Case Synopsis A 10-year-old girl with a history of motion sickness is scheduled for adenotonsillectomy. This will be her third surgery under general anesthesia. She had multiple episodes of postoperative nausea and vomiting (PONV) after the two previous procedures (dental…
Case Synopsis A 2.5-kg, 4-month-old male infant presents for a large, irreducible inguinal hernia repair. His history is significant for premature birth at 26 weeks of gestation, intraventricular hemorrhage, and immature lung disease requiring mechanical ventilation for 3 weeks. He…
Case Synopsis A 5-year-old obese child with developmental delay, asthma, and obstructive sleep apnea presents for a tonsillectomy. Inhalation induction is begun. The airway is partially obstructed intermittently until nasopharyngeal and oral airways are inserted. On completion of surgery, pink,…
Case Synopsis A 4-year-old girl undergoes a general anesthetic for laparoscopic repair of an umbilical hernia. A few minutes after arriving in the postanesthesia care unit, she is noted to have inspiratory stridor. Problem Analysis You’re Reading a Preview Become…
Case Synopsis A 5-year-old boy with eosinophilic gastroenteritis, chronic dysphagia and vomiting, and radiographic evidence of delayed gastric emptying presents for repeat esophagogastroduodenoscopy to evaluate disease progression. Previous endoscopy studies have revealed the presence of stomach contents despite adherence to…
Case Synopsis After extubation at the conclusion of adenotonsillectomy, a 5-year-old boy coughs and then develops high-pitched inspiratory stridor that progresses to silent rocking chest movements. Chest wall retractions are noted, and the breath sounds diminish until none are heard.…
Case Synopsis A healthy 12-year-old boy is undergoing a tympanomastoidectomy under general anesthesia with sevoflurane in oxygen and air, and supplemented with fentanyl. He has also received dexamethasone, ondansetron, and cefazolin. Approximately 2 hours into the case, he is noted…
Case Synopsis A 5-year-old girl with no prior ophthalmic history has a thyroglossal duct cyst excision under general anesthesia. On awakening, she complains that “something hurts in my eye.” Although there is no obvious foreign body in the eye, excessive…
Case Synopsis A healthy 12-year-old boy presents for reduction of a humerus fracture. Anesthesia is induced with sevoflurane. Fifteen minutes later, there is an abrupt increase in end-tidal carbon dioxide to greater than 70 mm Hg. He becomes tachycardic, with…
Case Synopsis A 25-year-old woman with spina bifida was undergoing flexible cystoscopy through a suprapubic catheter. She underwent several genitourinary procedures in the past and has been self-catheterizing for 10 years. Twenty minutes after an uneventful anesthetic induction and endotracheal…