A 28-year-old woman receives a lumbar epidural anesthetic for uncomplicated labor and delivery. During removal of the catheter, 1 cm breaks off and remains in her back. After informing the patient, the most appropriate management is
In a 45-year-old patient with severe mitral regurgitation, which of the following is the most important hemodynamic condition to avoid during induction of anesthesia?
(A) Decreased heart rate to less than 60 bpm
(B) Increased heart rate to greater than 90 bpm
(C) Increased preload
(D) Increased afterload
(E) Enhanced myocardial contractility
D
During active labor, 10 ml of bupivacaine 0.5% with epinephrine 1:200,000 is administered epidurally. Fifteen minutes later, maternal blood pressure is 70/50 mmHg and heart rate is 70 bpm; fetal heart rate is 90 bpm for 45 seconds, with loss of beat-to-beat variability. The most likely explanation for the fetal vital signs is
During cardiopulmonary bypass, the perfusionist notes that the mixed venous oxygen saturation has decreased from to 55%. Which of the following is the most likely cause?
(A) Administration of a nitroprusside bolus
(B) Administration of a thiopental bolus
(C) Decrease in rectal temperature from 34°C to 28°C
A patient has sudden cardiopulmonary arrest five minutes after retrobulbar block with 0.75% bupivacaine 2 ml with hyaluronidase for ophthalmologic surgery. No premonitory changes were noted on the pulse oximeter. The most likely cause is
(A) allergic reaction to hyaluronidase
(B) direct cardiac toxicity
(C) oculocardiac reflex
(D) intravenous injection of local anesthetic
(E) subarachnoid injection of local anesthetic
E
Which of the following statements concerning the choice of nitroprusside or nitroglycerin to induce deliberate hypotension is true?
(A) Nitroglycerin is more potent
(B) Nitroglycerin produces hypotension by acting on both arterial and venous capacitance vessels
(C) Nitroprusside produces less rebound hypertension on discontinuation
(D) The toxic effects of nitroprusside are independent of dose
(E) The therapeutic effects of nitroprusside may persist on discontinuation
B
Hyperkalemia in response to the administration of an intubating dose of succinylcholine is associated with each of the following disorders EXCEPT