Case Synopsis 1 A 65-year-old man undergoes open reduction and internal fixation of a tibial fracture under general anesthesia (GA). He has a history of hypertension and diabetes mellitus. He was on ramipril and metformin. GA drugs included midazolam 2…
Case Synopsis A 25-year-old woman in the postanesthesia care unit (PACU) complains of pain and a foreign body sensation in her right eye. Earlier that day, she underwent nasal polypectomy under general endotracheal anesthesia. Physical examination reveals residual petroleum-based ointment…
Case Synopsis A 71-year-old man is referred to the pain management center for abdominal pain secondary to a diagnosis of metastatic pancreatic cancer. The patient recently underwent a local anesthetic block of the celiac plexus with 80% relief of his…
Case Synopsis A 6-year-old boy with a history of mild intermittent asthma is scheduled for urgent laparoscopic appendectomy. After preoxygenation and a rapid-sequence induction, the patient is easily intubated. There is no sign of aspiration. After intubation, peak inspiratory pressure…
Case Synopsis During an open abdominal aortic aneurysm repair, a 71-year-old man suddenly becomes profoundly hypotensive after acute blood loss. The mean arterial blood pressure is 40 mm Hg, and the electrocardiogram (ECG) shows a wide complex rhythm of 35…
Case Synopsis “I thought I was about to die. [One minute] I was wheeled into a fairly routine orthodontic operation. … Suddenly, I was aware something had gone very wrong. I could hear what was going on around me, and…
Case Synopsis A 35-year-old man with T1 spinal cord transection 3 years ago, sustained in a motorcycle accident, is scheduled for elective cystoscopy with removal of a bladder stone. In the preoperative holding area, he feels anxious and has a…
Case Synopsis A 57-year-old hypertensive African American woman with recent initiation of angiotensin-converting enzyme (ACE) inhibitor undergoes laparoscopic cholecystectomy under general endotracheal anesthesia. After 1 hour in the recovery room, the patient complains that her tongue feels “thick.” On examination…
Case Synopsis A 54-year-old woman presents for a hysterectomy and oophorectomy for ovarian mass. She is induced with propofol, fentanyl, and vecuronium. Sevoflurane in air/oxygen is delivered for maintenance. She receives 2 g of cefotetan shortly after intubation. Within the…
Case Synopsis A 23-year-old woman undergoes emergency cesarean section under general anesthesia for fetal bradycardia and placental abruption. She is hypotensive (blood pressure 70/30 mm Hg) and tachycardic (heart rate 150 beats per minute) as the procedure begins. After delivery,…