Case Synopsis After extubation at the conclusion of adenotonsillectomy, a 5-year-old boy coughs and then develops high-pitched inspiratory stridor that progresses to silent rocking chest movements. Chest wall retractions are noted, and the breath sounds diminish until none are heard.…
Case Synopsis A healthy 12-year-old boy is undergoing a tympanomastoidectomy under general anesthesia with sevoflurane in oxygen and air, and supplemented with fentanyl. He has also received dexamethasone, ondansetron, and cefazolin. Approximately 2 hours into the case, he is noted…
Case Synopsis A 5-year-old girl with no prior ophthalmic history has a thyroglossal duct cyst excision under general anesthesia. On awakening, she complains that “something hurts in my eye.” Although there is no obvious foreign body in the eye, excessive…
Case Synopsis A 25-year-old woman with spina bifida was undergoing flexible cystoscopy through a suprapubic catheter. She underwent several genitourinary procedures in the past and has been self-catheterizing for 10 years. Twenty minutes after an uneventful anesthetic induction and endotracheal…
Case Synopsis A 9-month-old boy, American Society of Anesthesiologists (ASA) class II, is undergoing craniosynostosis repair with general anesthesia consisting of 2.5% sevoflurane with oxygen and fentanyl. He has an endotracheal tube in place and is positioned prone on a…
Case Synopsis An otherwise healthy 5-year-old girl with adenotonsillar hypertrophy secondary to recurrent infections underwent an uneventful tonsillectomy and adenoidectomy with general anesthesia, was extubated, and was sent to recovery. The recovery nurse notifies you that the patient is stridulous…
Case Synopsis A 3-month-old girl, born at 32 weeks of gestation, presents to the magnetic resonance imaging (MRI) scanner for sedation for MRI of the brain. Her weight is 4.2 kg, and she is on nothing-by-mouth status for 6 hours.…
Case Synopsis An otherwise healthy 4-year-old boy is scheduled for inguinal hernia repair. He has dinner at 5 pm the evening before surgery, as well as milk and cookies before going to bed at 9 pm . He is offered…
Case Synopsis An otherwise healthy 4-year-old boy undergoes general anesthesia for circumcision. The surgery proceeds without incident. When the child arrives in the postanesthesia care unit (PACU), he is noted to be restless, irritable, crying, and not responsive to routine…
Case Synopsis A 3-year-old child is scheduled for tonsillectomy and adenoidectomy. His past medical history is significant for Treacher Collins syndrome ( Fig. 188.1 ), and thus a difficult airway is anticipated. After inhalation induction with spontaneous respirations, successful intubation…