A 15-kg, 3-year-old child is anesthetized for an inguinal hernia repair with halothane and nitrous oxide. The trachea is intubated after administration of succinylcholine 30 mg. At the conclusion of the 45-minute procedure, the child is not breathing; a peripheral nerve twitch monitor indicates no response to a train-of-four stimulus. Further investigation is most likely to show
(A) abnormal response to nondepolarizing muscle relaxants
(B) a low dibucaine number
(C) a low plasma cholinesterase concentration
(D) an underlying myopathy
(E) a positive halothane-caffeine contracture test
Which of the following EEG findings is expected during maintenance anesthesia with high-dose fentanyl (50 ju-g/kg), nitrous oxide, and oxygen?
(A) Low-frequency high-voltage activity
(B) Nondominant hemispheric slowing
(C) Predominant alpha activity
(D) Prominent beta activity
(E) Spindle-shaped bursts
A
During cardiopulmonary bypass at a nasopharyngeal temperature of 28°C and a hematocrit of 20%, temperature-corrected PaCO2 is 50 mmHg and uncorrected PaCO2 is 60 mmHg. The most appropriate management is to
(A) administer additional opioid
(B) administer packed red blood cells to increase hematocrit to 25%
A patient with moderate hypothyroidism and unstable angina requires urgent coronary artery bypass grafting. Which of the following is most appropriate before proceeding with the operation?
(A) Initiation of epinephrine infusion
(B) Intramuscular administration of a barbiturate
(C) Intravenous administration of triiodothyronine (T3)
A 70-kg man with ischemic heart disease is undergoing abdominal aortic aneurysm resection. At the time of infrarenal cross-clamping, 0.2-mV ST-segment depression appears on lead V5 of the ECG. Hemodynamic changes occurring at the same time are shown below. Systemic blood pressure 90/50 --> 150/90; Heart rate 80 --> 95; PAp 20/10 --> 45/24; Mean pulmonary artery occlusion pressure (mmHg) 10 --> 23; Cardiac output (L/min) 4.5 --> 3.2. Ischemia would be decreased by restoring the pre-clamp level of each of the following EXCEPT