Case Synopses Case 1 A 72-year-old man is scheduled to undergo transverse colectomy and primary reanastomosis for a nonobstructing carcinoma. He has a history of hypertension that is well controlled by a diuretic and is otherwise healthy. Case 2 A…
Case Synopsis Following emergence and tracheal extubation after general anesthesia with neuromuscular relaxation, a 52-year-old woman with a history of chronic renal insufficiency has labored breathing with paradoxic movement of the chest wall and abdomen and intermittent upper airway obstruction.…
Case Synopsis A 53-year-old, 75-kg man with a past medical history significant for poorly controlled hypertension and non–insulin-dependent diabetes is scheduled for an external fixation of a femur fracture sustained after a fall off a ladder 2 days ago. The…
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…