A patient with alcoholic cirrhosis, ascites, and gastrointestinal bleeding receives 4 units of red blood cells prior to anesthesia with isoflurane in oxygen for emergency exploratory laparotomy. After the peritoneum is opened and the fluid is drained, blood pressure decreases to 60/40 mmHg and SpO2 decreases to 90%. The most likely cause of the hypoxemia is
(A) acute myocardial ischemia
(B) decreased 2,3-diphosphoglycerate in transfused blood
A 33-year-old woman is scheduled for emergency appendectomy under general anesthesia. She has hypertrophic cardiomyopathy and has had two episodes of syncope in the past year. Which of the following statements concerning anesthetic management is true?
(A) Spinal anesthesia is preferred to general anesthesia
(B) Deep levels of isoflurane anesthesia are appropriate
(C) Fluid administration should be restricted
(D) Phenylephrine is preferred to ephedrine to treat hypotension
(E) Positive end-expiratory pressure will decrease left ventricular outflow obstruction
A healthy 57-year-old man with a ureteral calculus is scheduled for immersion extracorporeal shock wave lithotripsy. Which of the following statements is true?
(A) Delivery of the shock wave is timed by the R wave of the ECG
(B) Continuous epidural anesthesia is contraindicated because of the risk for infection
(C) If a regional technique is used, a T10 sensory level is required for adequate anesthesia
(D) If general anesthesia is used, high tidal volumes and low respiratory rate are preferred
(E) Removal of the patient from the bath is accompanied by an increase in blood pressure