Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with
(A) longer duration
(B) more rapid onset
(C) more intense block
(D) more difficult reversibility
(E) similar pharmacokinetics
A
A 30-year-old man who is breathing spontaneously has a ventilatory pattern of sustained deep inspiration and occasional expiratory gasps during emergence from general anesthesia after posterior fossa craniotomy. Which of the following is the most likely cause?
Neuromuscular blockade of the diaphragm is best ensured by monitoring which of the following peripheral muscles?
(A) Adductor pollicis muscle
(B) First dorsal interosseous muscle
(C) Flexor hallucis muscle
(D) Muscles of the hypothenar eminence
(E) Orbicularis oculi muscle
E
For 30 minutes, a patient has been receiving oxygen 2 L, nitrous oxide 2 L, and halothane from an agent-specific vaporizer set at 1%. A mass spectrometer sampling gas from the patient's airway shows an end-tidal halothane concentration of 0.7%. The most likely explanation for this difference is
During laser excision of vocal cord polyps in a 5-year-old boy, dark smoke suddenly appears in the surgical field. The trachea is intubated and anesthesia is being maintained with halothane, nitrous oxide, and oxygen. The most appropriate initial step is to
A 70-kg patient experiences pain on incision of a thigh abscess. The area around the abscess had been infiltrated with 30 ml of 1% lidocaine in 1:200,000 epinephrine. The local anesthetic was most likely ineffective because of
(A) acidosis at the site of the injection
(B) epinephrine-induced limitation of drug diffusion