Case Synopsis A 7-week-old infant underwent a Kasai procedure for the diagnosis of biliary atresia. The patient received isoflurane and nitrous oxide, and the operation was uneventful. Five days after the surgery, the patient developed hypotonia, hyporeflexia, and apnea. Computed…
Case Synopsis A 2-year-old boy presents for inguinal herniorrhaphy. During mask induction with oxygen, nitrous oxide, and sevoflurane, he develops laryngospasm, which is treated with intramuscular succinylcholine. A wide-complex QRS tachycardia is subsequently noted on the electrocardiogram monitor. Problem Analysis…
Case Synopsis A 4-year-old boy with a 10-day history of persistent nausea, vomiting, and otitis media requires magnetic resonance imaging (MRI) of the brain to evaluate possible intracranial process. The anesthesiology consultant was called to evaluate and assist with the…
Case Synopsis A 23-year-old pregnant woman at 34 weeks and 3 days’ gestation with severe preeclampsia is brought emergently to the operating room for cesarean delivery under general anesthesia. She is currently receiving a magnesium infusion for treatment of her…
Case Synopsis A 22-year-old woman is posted for an emergency appendectomy. She is hemodynamically stable and administered a spinal anesthesia. The surgeon makes the abdominal incision, but on deeper dissection the patient cries out in pain. The anesthesiologist administers bolus…
Case Synopsis An otherwise healthy 26-year-old woman undergoes cesarean section for delivery of a breech infant. Spinal anesthesia is used, consisting of 1.6 mL of 0.75% hyperbaric bupivacaine (12 mg) with preservative-free morphine (0.3 mg). The surgery is uneventful, and…
Case Synopses Hypokalemia A 70-year-old man with hypertension is anesthetized for emergency surgery for a bowel obstruction. His only daily medication is hydrochlorothiazide. His preoperative serum potassium concentration was 3.4 mEq Intraoperative oliguria is treated with 10 mg of intravenous…
Case Synopsis An anxious 24-year-old woman presents with nausea, vomiting, and abdominal pain and is scheduled for exploratory laparotomy. Past history is remarkable for a negative exploratory laparotomy 2 years ago. Blood pressure is 150/90 mm Hg, and pulse is…
Case Synopsis A 34-year-old male veteran who sustained a complete spinal cord injury at C5 during combat 10 years ago underwent a cystoscopy with ureteral stent placement under conscious sedation. During the procedure the patient became hypertensive to 260/120 mm…
Case Synopsis A 90-year-old man with a past medical history of multiinfarct dementia presented with hematuria and is found to be confused and agitated in the postanesthesia care unit after cystourethroscopy. The patient received midazolam preoperatively, fentanyl and propofol on…