Case Synopsis An 8-week-old infant is undergoing a craniectomy for sagittal craniosynostosis. As the surgeon is excising the cranial bone segment, precordial Doppler sounds change, and the blood pressure rapidly declines ( Fig. 127.1 ). Problem Analysis Definition Gas bubbles…
Case Synopsis A 38-year-old woman with a history of hypertension and obesity (body mass index 32) is scheduled to undergo a laparoscopic cholecystectomy for chronic recurrent cholecystitis. In the preoperative assessment, she discusses her allergy to penicillin with the anesthesiologist.…
Case Synopsis A 62-year-old man underwent coronary artery bypass graft surgery via a median sternotomy, with harvesting of the internal mammary artery. During a routine postoperative visit, the patient complains of a “tingling” sensation in the fourth and fifth fingers…
Case Synopsis A 68-year-old man with a history of insulin-dependent diabetes mellitus, hypertension, and an 80 pack-year smoking history is scheduled for four-vessel coronary artery bypass grafting (CABG). After uneventful induction of anesthesia, severe aortic atheromatous disease is observed via…
Case Synopsis A 54-year-old man, American Society of Anesthesiologists (ASA) physical status 2, undergoes general anesthesia for a laparoscopic ventral hernia repair. His baseline blood pressure is 120/70 mm Hg. After an uneventful intravenous induction and tracheal intubation, the sevoflurane…
Case Synopsis A 75-year-old woman undergoing emergency coronary artery bypass graft surgery for unstable angina has incomplete revascularization due to lack of a suitable conduit. Insertion of a transesophageal echocardiography (TEE) probe during cardiopulmonary bypass is difficult. After several attempts,…
Case Synopsis A 59-year-old man is having an open resection of the right colon for cancer. The surgeon is having a difficult time getting exposure, due to adhesions from a previous surgery. On several occasions, he complains that the electrosurgical…
Case Synopsis A 25-year-old man with no significant medical history presents for tonsillectomy. After induction of anesthesia and tracheal intubation, anesthesia was maintained using a mixture of O 2 /N 2 O/isoflurane at a total fresh gas flow (FGF) of…
Case Synopsis A 65-year-old man is brought to the operating room for emergent repair of a ruptured abdominal aortic aneurysm. The patient is intubated, hypothermic (34.5°C), and hypotensive (blood pressure 85/60 mm Hg). Volume resuscitation is instituted with warmed intravenous…
Definition Pneumorrhachis is the presence of air within the spinal canal (either in the intra- or extradural space). It is a rare phenomenon and is often asymptomatic. This condition was first reported in 1977 by Gordon et al. who used the…