Case Synopsis An anxious 24-year-old woman presents with nausea, vomiting, and abdominal pain and is scheduled for exploratory laparotomy. Past history is remarkable for a negative exploratory laparotomy 2 years ago. Blood pressure is 150/90 mm Hg, and pulse is…
Case Synopsis A 34-year-old male veteran who sustained a complete spinal cord injury at C5 during combat 10 years ago underwent a cystoscopy with ureteral stent placement under conscious sedation. During the procedure the patient became hypertensive to 260/120 mm…
Case Synopsis A 90-year-old man with a past medical history of multiinfarct dementia presented with hematuria and is found to be confused and agitated in the postanesthesia care unit after cystourethroscopy. The patient received midazolam preoperatively, fentanyl and propofol on…
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…