A 6-year-old boy undergoes craniotomy in the supine position for brain tumor during anesthesia with 1.5% isoflurane in oxygen. PetCO2 is 38 mmHg, heart rate is 78 bpm, and blood pressure is 130/80 mmHg. After opening the dura, the surgeon notes that the brain is bulging. Which of the following management options is LEAST likely to significantly decrease brain size?
Which of the following factors will slow the induction of anesthesia in patients receiving volatile anesthetics?
(A) Addition of 70% nitrous oxide
(B) Increased cardiac output
(C) Increased minute ventilation
(D) Low blood/gas solubility coefficient
(E) Previous pneumonectomy
B
A 26-year-old woman has weakness on extension of the right knee one day after uneventful vaginal delivery under spinal anesthesia with lidocaine. The most likely cause is
(A) femoral nerve injury from thigh abduction
(B) obturator nerve injury from obstetric forceps
(C) peroneal nerve compression from the leg support
(D) saphenous nerve injury from the stirrups
(E) chemical arachnoiditis following the spinal anesthetic
A
The shorter duration of action of alfentanil relative to fentanyl is due to its
(A) greater lipid solubility
(B) increased clearance
(C) increased rate of hepatic metabolism
(D) lesser protein binding
(E) smaller volume of distribution
E
Diplopia following lumbar puncture with a 25-gauge, 3 1/2-inch needle is the result of
(A) stretching the abducens nerve
(B) pressure on the optic nerve
(C) distortion of the oculomotor nucleus from collapse of the wall of the third ventricle
In a 5-kg child, the end-tidal carbon dioxide tension is 35 mmHg during spontaneous ventilation through a Mapleson D system. Which single change is most likely to increase this value?