A 48-year-old woman underwent a posterior fossa craniotomy in the sitting position. Monitoring included precordial Doppler, arterial blood pressure, central venous pressure (CVP), and urine output. Furosemide was used intraopera-tively for cerebral decompression, and the operation was uneventful. In the recovery room, she was awake with stable vital signs when the CVP suddenly increased from 6 to 25 mmHg without any change in blood pressure. Shortly thereafter, premature ventricular contractions are noted. After administering lidocaine 1 mg/kg intravenously, the most appropriate action is to
A 35-year-old woman with systemic lupus erythematosus is admitted to the critical care unit following sudden onset of severe chest pain. Examination shows tachycardia, hypotension, pulmonary edema, and a blowing systolic murmur in the left parasternal region. The most appropriate management is
When methylmethacrylate is inserted into the femur, each of the following may occur EXCEPT
Blind nasotracheal intubation is contraindicated in the presence of
A computer program for hemodynamic calculations has the following input values: body surface area, arterial blood pressure, heart rate, pulmonary artery occlusion pressure, pulmonary artery pressure, and cardiac output. Each of the following values can be derived with this program EXCEPT
A 1100-g, 10-day-old infant is to undergo ligation of a patent ductus arteriosus after unsuccessful medical treatment. Within three minutes of intravenous administration of atropine 20 mcg, fentanyl 20 mcg, and pancuronium 0.1 mg, systemic blood pressure decreases from 80 to 30 mmHg, heart rate from 180 to 140 bpm, and arterial oxygen saturation from 90% to 80%. The most appropriate management is to
A 30-year-old woman develops urticaria immediately after administration of 2% 2-chloroprocaine for removal of a nevus on the chest wall. This reaction resolves with administration of diphenhydramine and the surgery is rescheduled. During the second procedure, a field block is performed using 10 ml of 1% lidocaine from a multidose vial. Within 10 minutes the patient develops urticaria and wheezing and has difficulty breathing. These symptoms resolve with administration of epinephrine. Which of the following substances is the most likely cause of these reactions?
Which of the following drugs used to produce or reverse muscle relaxation has the greatest prolongation of action in a patient with end-stage renal disease?
A patient is hyperventilated to a PaC02 of 20 mmHg. Which of the following physiologic parameters is most likely to be increased?
During laser excision of vocal cord polyps in a 5-year-old boy, dark smoke suddenly appears in the surgical field. The trachea is intubated and anesthesia is being maintained with halothane, nitrous oxide, and oxygen. The most appropriate initial step is to