Case Synopsis It is the first day of operation of the hospital’s new outpatient surgery wing. The anesthesiologist reports to work looking forward to a day of easy cases consisting of healthy American Society of Anesthesiologists class I outpatients. During…
Case Synopsis A 76-year-old man is brought to the operating room emergently for open repair of a right ileac artery injury. The patient is placed on an under-body blanket that is connected to a properly functioning forced-air warming system, and…
Case Synopsis A 100-kg, 68-year-old man is anesthetized and intubated. Bilateral breath sounds are verified. The ventilator is turned on and set to a tidal volume of 600 mL, respiratory rate of 10, and inspiratory-expiratory ratio of 1:2. Two minutes…
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…