Case Synopsis A 30-year-old female patient was scheduled for hysteroscopy as a day-case procedure. She has no past medical history of relevance. Metoclopramide 10 mg and ondansetron 4 mg were administered followed by propofol/fentanyl via intravenous induction and sevoflurane for…
Case Synopsis A 23-year-old man presents for reduction and fixation of an open tibial fracture after falling off a horse. During the presurgical briefing/time-out, the surgeon requests that the patient be given vancomycin, 1 g, before incision. After propofol and…
Complications of Aortic Root Cannulation: Acute Aortic Root Dissection Case Synopsis A 75-year-old man with a history of calcific aortic stenosis was scheduled for valve replacement. Induction of anesthesia, sternotomy, and insertion of perfusion cannulas were uneventful. However, the aortic…
Case Synopsis A 25-year-old restrained male driver involved in a rollover motor vehicle accident presents acutely for repair of bilateral open tibia fractures. Loss of consciousness was reported at the scene. The patient is currently alert but disoriented, with a…
Case Synopsis An 80-year-old man with previous abdominal aortic aneurysm (AAA) repair presents with abrupt-onset back pain starting 1 hour ago. He is alert, diaphoretic, tachycardic, and hypertensive. He is given oxygen, nitroglycerin, and morphine. He was found to have…
Case Synopsis You are an anesthesiologist on call, and a surgical resident covering the burn unit books an emergency extremity fasciotomy. The patient, a 40-year-old homeless man, was rescued from a burning garage and admitted to the burn unit the…
Case Synopsis A 32-year-old man presents to the emergency department following a motorcycle accident in which he was thrown to the roadside. He is mildly obtunded, smells of alcohol, and is difficult to examine neurologically, but he appears to have…
Case Synopsis An obese 10-year-old child with enlarged tonsils and a history of sleep apnea is scheduled to undergo magnetic resonance imaging (MRI). She is sedated by the hospital sedation service, which is staffed by pediatric intensive care physicians. The…
Case Synopsis Monitored anesthesia care is provided for an active 70-year-old patient undergoing phacoemulsion of a cataract with intraocular lens implantation. The patient has stable hypertension, coronary artery disease, mild emphysema, and renal insufficiency. Sedation with 1 mg midazolam is…
Case Synopsis A 55-year-old man with end-stage lung disease undergoes bilateral lung transplantation for usual interstitial pneumonitis. After reperfusion of the second lung the patient develops ischemia-reperfusion injury with acute graft dysfunction, pulmonary hypertension, and right ventricular failure. Problem Analysis…