A 32-year-old man who is addicted to opioids complains of pain in the PACU one hour after fixation of a mandibular fracture. He has received intravenous morphine 30 mg during the past hour. The most appropriate management is
(A) continued intravenous administration of morphine until the pain resolves
(B) intravenous administration of nalbuphine in 5-mg increments until the pain resolves
(C) intramuscular administration of hydroxyzine 75 mg
(D) evaluation for entrapment of the mandibular nerve
A patient with alcoholic cirrhosis, ascites, and gastrointestinal bleeding receives 4 units of red blood cells prior to anesthesia with isoflurane in oxygen for emergency exploratory laparotomy. After the peritoneum is opened and the fluid is drained, blood pressure decreases to 60/40 mmHg and SpO2 decreases to 90%. The most likely cause of the hypoxemia is
(A) acute myocardial ischemia
(B) decreased 2,3-diphosphoglycerate in transfused blood
A 27-year-old man with a one-month history of quadriplegia at a C6 level is given general anesthesia for cystoscopy. During the cystoscopy, blood pressure suddenly increases to 220/120 mmHg. Further evaluation is most likely to show
Arterial pressure in the radial artery is 155/70 mmHg measured by a correctly calibrated catheter-transducer system. At the same time, aortic pressure is 140/75 mmHg using a high-fidelity catheter tip transducer. The most likely cause of this discrepancy is
(A) a large amount of air in the dome of the radial artery transducer
(B) coarctation of the aorta
(c) peripheral vascular constriction produced by sympathetic stimulation
(D) physiologic amplification of the waveform from the aorta to the radial artery
(E) too high a frequency response in the catheter-transducer system
A 75-year-old woman with significant carotid artery stenosis is scheduled for general anesthesia for repair of a fractured hip. Which of the following is the greatest disadvantage of using propofol as an induction agent in this patient?
A 1100-g, 10-day-old infant is to undergo ligation of a patent ductus arteriosus after unsuccessful medical treatment. Within three minutes of intravenous administration of atropine 20 mcg, fentanyl 20 mcg, and pancuronium 0.1 mg, systemic blood pressure decreases from 80 to 30 mmHg, heart rate from 180 to 140 bpm, and arterial oxygen saturation from 90% to 80%. The most appropriate management is to
A 65-year-old man has a history of alcohol abuse. Which of the following preoperative serum concentrations would provide the best assessment of synthetic hepatic function?