A 75-year-old man received an uneventful epidural anesthetic for total knee arthroplasty. Twenty-four hours later he has a painless flaccid paralysis in both legs. This clinical presentation is most consistent with
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 patient is placed in the prone jackknife position for lumbar subarachnoid injection of tetracaine 10 mg in 10 ml of preservative-free sterile water. Which of the following results is most likely?
A 40-year-old woman with Graves' disease is undergoing thyroidectomy with 1% isoflurane, 60% nitrous oxide, and oxygen. During surgical manipulation of the thyroid, temperature increases to 38.5°C, heart rate to 160 bpm, and blood pressure to 150/100 mmHg. The most appropriate initial treatment is to
A 2.2-kg, 6-hour-old neonate is to undergo gastrostomy followed by repair of a tracheoesophageal fistula. During induction with halothane, air, and oxygen, the abdomen becomes distended. Appropriate management is to
Four hours after open cholecystectomy, a patient who is breathing spontaneously has an SpO2 of 93% in the supine position and an SpO2 of 98% when placed in the head-up position. The most likely cause of this change is an increase in which of the following?
An otherwise healthy 42-year-old woman is referred for management of pain associated with adenocarcinoma of the breast and metastasis to the anterior body of L3. She perceives the pain as moderate and currently takes no pain medication. Her oncologist estimates her life expectancy to be 18 months. The most appropriate initial management is
During carotid endarterectomy, which of the following EEG patterns is most suggestive of cerebral ischemia?
A newborn is in respiratory distress. Examination shows a scaphoid abdomen, cyanosis while breathing oxygen by mask, and heart sounds in the right hemithorax. Which of the following is the most appropriate next step?
Fresh frozen plasma is indicated in each of the following situations EXCEPT