One week after sustaining third-degree burns over 40% of his body surface area, a patient requires general anesthesia for debridement and skin grafting. Which of the following responses to neuromuscular blockers is most likely?
(A) Clinically insignificant increases in serum potassium concentration after administration of succinylcholine 1 mg/kg
(B) Increased risk of hyperkalemia after administration of succinylcholine 1 mg/kg
(C) Increased sensitivity to vecuronium
(D) Laudanosine toxicity after administration of atracurium 0.4 mg/kg
(E) Normal serum potassium concentration if administration of succinylcholine is preceded by d-tubocurarine 3 mg
A 70-kg, 20-year-old athlete receives nitrous oxide and oxygen, thiopental, and fentanyl 1.25 mg (25 ml) during a knee reconstruction procedure lasting three hours. Postoperatively, he does not awaken or resume spontaneous breathing for three hours. The most likely explanation for the prolonged effect of fentanyl is
(A) dose-dependent elimination half-life
(B) genetically slow biotransformation
(C) large volume of distribution
(D) presence of an active metabolite in high concentration
If administered prior to induction of anesthesia, which of the following drugs is most likely to cause tachycardia?
(A) Fentanyl
(B) Meperidine
(C) Midazolam
(D) Morphine
(E) Sufentanil
B
A conscious patient has an acute subdural hematoma that will require surgical evacuation. Which of the following interventions to be carried out in the emergency department is most likely to decrease intracranial pressure?
(A) Having the patient hyperventilate
(B) Intravenous administration of an opioid
(C) Intravenous administration of a corticosteroid
(D) Intravenous administration of nitroprusside
(E) Intravenous administration of furosemide
E
A 67-year-old man undergoes spinal anesthesia with hyperbaric tetracaine 10 mg for transurethral resection of the prostate. At the end of the 50-minute procedure, the level of anesthesia is T6 and blood pressure is 120/70 mmHg. Within two minutes after transfer to a stretcher, the patient has nausea and blood pressure decreases to 76/42 mmHg. Which of the following is the most likely cause of the acute hypotension?
During axillary block of the brachial plexus, which nerve is most likely to be encountered if the needle is inserted through the posterior wall of the artery?