A 30-year-old man who is undergoing laparotomy and resection of a large kidney tumor has a decrease in SpO2 from 100% to 92% and an increase in peak airway pressure from 20 to 35 cm H2O. Plateau pressure is unchanged at 18 cm H2O. Which of the following is the most likely cause?
Four days after subarachnoid hemorrhage and surgical clipping of a cerebral aneurysm, a patient develops cerebral artery vasospasm. Appropriate treatment includes each of the following EXCEPT
(A) administration of nimodipine
(B) controlled hypertension
(C) hemodilution to hematocrit of 33%
(D) hyperventilation to PaC02 of 25 to 30 mmHg
(E) increasing preload
D
Which of the following is a cardiorespiratory effect of epidural block to a T4 sensory level?
After tracheal extubation, a healthy 21-year-old man has a 30-second episode of laryngospasm with marked intercostal and sternal retractions, which are corrected with continuous positive airway pressure administered by mask. He now has dyspnea and tachypnea, and a roentgenogram of the chest shows diffuse bilateral interstitial edema. The most likely cause is increased
A patient receiving monoamine oxidase inhibitor therapy for depression undergoes an emergency cholecystectomy. Which of the following is the best means of providing postoperative analgesia in this patient?
(A) Epidural analgesia using 0.25% bupivacaine
(B) Intravenous meperidine
(C) Epidural analgesia using meperidine
(D) Epidural analgesia using 1% lidocaine with epinephrine
(E) Intercostal analgesia using 1% lidocaine with epinephrine
In a 5-kg child, the end-tidal carbon dioxide tension is 35 mmHg during spontaneous ventilation through a Mapleson D system. Which single change is most likely to increase this value?
A 75-year-old man in the PACU complains of severe pain following thoracotomy. Respiratory rate is 30/min; arterial blood gas values are PaO2 70 mmHg, PaCO2 56 mmHg, and pH 7.28 at an FiO2 of 0.6. The patient has a thoracic epidural catheter and received epidural morphine 2 mg 45 minutes earlier. Which of the following is the most appropriate immediate management?
(A) Intravenous administration of naloxone
(B) Epidural administration of additional morphine