The initial reduction in core temperature during general anesthesia is caused by
A 27-year-old man with type I von Willebrand's disease requires internal fixation of an open fracture of the femur. Prothrombin time, partial thromboplastin time, and platelet count are normal. During surgery, there is significant oozing from the wound and the surgeon notes poor clot quality. The most appropriate therapy at this time is administration of
A 2.8-kg newborn undergoes repair of a moderate-sized omphalocele. Intravenous fluid is administered at 14 mL/hr. Forty-five minutes after beginning surgery and before reduction of the omphalocele, arterial blood pressure decreases from 80/40 to 55/30 mmHg. SaO2 is 98% at an FiO2 of 0.5. Breath sounds are equal bilaterally. Which of the following is the most likely explanation for the decrease in blood pressure?
A 65-kg, 57-year-old man has an initial activated clotting time (ACT) of 122 seconds prior to elective cardiopulmonary bypass. Five minutes after administration of heparin 200 mg, ACT increases to 154 seconds. After two additional doses of 200 mg each from different lots, ACT increases to 240 seconds. The most appropriate next step is to
A 76-year-old patient is restless and hallucinating in the preoperative holding area. He received morphine 5 mg and scopolamine 0.4 mg intramuscularly as premedication and is now breathing oxygen 2 L/min through nasal prongs. SpO2 is 98%. Which of the following is the most appropriate next step?
Which of the following findings is most likely in an 85-kg 30-year-old man who is breathing spontaneously through 6-mm endotracheal tube?
A man with alcoholic cirrhosis and a hemoglobin concentration of 10 g/dl has an intraoperative PaO2 of 75 mmHg at an FiO2 of 0.5. Which of the following is the most likely cause of the low PaO2?
A patient with a fasting blood glucose concentration of 100 mg/dL undergoes a four-hour operation under general anesthesia without intraoperative administration of glucose. On emergence the most likely finding will be
A 72-year-old man has had residual hemiparesis since having a cerebrovascular accident three years ago. Compared with the response of the unaffected limbs to nondepolarizing muscle relaxants, the hemiparetic limbs will show
A combined epidural and general anesthetic is used for aortofemoral bypass surgery. Just prior to extubation, the patient received morphine 5 mg through the epidural catheter. Eleven hours later, he is unresponsive while breathing 40% oxygen from a face mask. Respiratory rate is 6/min and SpO2 is 92%. Arterial blood gas analysis shows PaO2 80 mmHg, PaCO2 84 mmHg, and pH 7.16. Which of the following statements concerning this patient is true?