Case Synopsis A 75-year-old man with metastatic non–small cell carcinoma of the lung is scheduled for bronchoscopic tumor ablation using laser, under general anesthesia. He has a chronic nonproductive cough, and a computed tomography scan reveals tumor encroachment on the…
Case Synopsis A 35-year-old man weighing 90 kg undergoes mandibular fracture fixation. He receives total intravenous anesthesia with propofol and remifentanil infusion, oxygen, and air for 4 hours. Twenty minutes before the end of surgery the patient has a heart…
Case Synopsis An 18-year-old man has open long bone fractures and severe traumatic brain injury due to a motor vehicle accident. His Glasgow Coma Scale score is 6, and a computed tomography scan of the head reveals diffuse cerebral edema.…
Case Synopsis Anesthesia induction has just been completed on a healthy 20-year-old man undergoing inguinal herniorrhaphy. Gas flows are set to 1 L/min of oxygen (O 2 ) and 2 L/min of nitrous oxide (N 2 O). The O 2…
Case Synopsis A 35-year-old man is brought to the operating room for an emergent awake tracheostomy after a gunshot wound to the face with facial and neck expanding hematomas. Chlorhexidine gluconate was used as antiseptic for the procedure, and the…
Case Synopses Macroshock A 50-year-old man in good general health is undergoing laparoscopic cholecystectomy under general anesthesia. In the middle of the procedure, the anesthesiologist feels a tingle, and the patient develops ventricular fibrillation. Immediate resuscitation and defibrillation restore normal…
Case Synopsis A 65-year-old man is taken to the operating room for coronary artery bypass grafting. After induction of anesthesia, a right internal jugular triple-lumen central venous catheter (CVC) is placed. The operation proceeds without complications, and the patient is…
Case Synopsis A 75-year-old woman with perforated diverticulitis is undergoing a laparoscopic hemicolectomy under general anesthesia. The patient’s abdomen has been insufflated with CO 2 to a pressure of 15 to 20 mm Hg for 45 minutes. The end-tidal CO…
Case Synopsis A 57-year-old woman who is a heavy smoker experiences a difficult endotracheal intubation during induction of anesthesia. Mask ventilation also is difficult, partly because of the high inspiratory pressures required and partly because of a poor mask fit,…
Case Synopses Case 1 A 75-year-old man underwent total knee replacement under spinal anesthesia with local anesthetic and 300 μg of diamorphine or 100 μg of morphine. Late that evening he appears extremely sleepy and has oxygen saturation of 94%…