Which of the following findings necessitates the preoperative insertion of a ventricular pacemaker in a 48-year-old man scheduled to undergo cholecystectomy?
(A) Atrial flutter with 3:1 atrioventricular block
(B) Bifascicular (right bundle branch block and left anterior hemiblock) block
(C) Left bundle branch block with first-degree atrioventricular block
A patient spontaneously breathes nitrous oxide 60%, oxygen 40%, and enflurane for one hour. The nitrous oxide is then replaced with oxygen, and the inspired enflurane concentration is increased from 1% to 2%. Over 10 minutes, the end-tidal carbon dioxide tension increases from 30 to 40 mmHg. The most likely cause is
A patient undergoes thoracotomy in the lateral decubitus position. Which of the following maneuvers is most likely to increase PaO2 during one-lung ventilation?
(A) Applying continuous positive airway pressure to the nondependent lung
(B) Applying positive end-expiratory pressure to the dependent lung
A patient has seizure activity 30 seconds after injection of 0.25% bupivacaine 2 ml with epinephrine 1:200,000 for stellate ganglion block. The most likely cause is
(A) reaction to epinephrine in the anesthetic solution
A 64-year-old patient with chronic obstructive pulmonary disease sustained fractures of ribs 4 through 8 on the left one hour ago. Examination shows agitation, heart rate of 120 bpm, respiratory rate of 30/min, and blood pressure of 180/100 mmHg. PaO2 is 70 mmHg and PaCO2 is 35 mmHg on room air. Radiographs of the chest show no abnormalities. Which of the following is the most appropriate immediate management?
(A) Continuous epidural analgesia using local anesthetics
(B) Mechanical ventilation
(C) Infusion of midazolam
(D) Patient-controlled analgesia with morphine sulfate
A 50-year-old woman develops stridor 10 hours after undergoing thyroidectomy. The most appropriate management is administration of which of the following drugs?