A 16-year-old girl is receiving isoflurane, nitrous oxide, oxygen, and pancuronium for insertion of a Harrington rod. In order to perform a "wake-up test" the muscle relaxant was antagonized with neostigmine 2.5 mg and atropine 1 mg. The patient abruptly moved all extremities and was given thiopental 100 mg and succinylcholine 100 mg rapidly. Forty-five minutes later no twitch could be elicited with a nerve stimulator. The most likely explanation is
(A) a dibucaine number of 20
(B) incomplete antagonism of pancuronium
(C) prolongation of the action of succinylcholine by neostigmine
(D) spinal cord damage caused by the abrupt arousal
(E) synergism between succinylcholine and pancuronium
A 27-year-old man with chronic renal failure is to undergo revision of an arteriovenous graft. He insists on general anesthesia. Hemodialysis was completed two hours ago, and serum potassium concentration is now 5 mEq/L. Which of the following statements concerning anesthetic management of this patient is true?
(A) Enflurane is contraindicated
(B) Succinylcholine is contraindicated
(C) Neostigmine will be required in larger than usual dosage
(D) The duration of action of atracurium will be prolonged
(E) The duration of action of propofol will be unchanged
E
Which of the following provides the most definitive diagnosis in a patient with suspected brain death?