When antagonizing neuromuscular block produced by pancuronium, the combination of simultaneously administered anticholinergic and anticholinesterase drugs that is most likely to produce bradycardia is
A woman with chronic obstructive pulmonary disease is extubated and minimally responsive after isoflurane anesthesia. She is receiving oxygen 6 L/min through a face mask. Respirations are 10/min, PaO2 is 68 mmHg, PaCO2 is 54 mmHg, and pH is 7.28. The most likely cause of the respiratory acidemia is
(A) blunted sensitivity to low pH in the medullary respiratory center
(B) chronic carbon dioxide retention
(C) decreased lung volume from supine positioning
(D) depression of carotid body chemoreceptors by halothane
(E) suppression of hypoxic ventilatory drive by supplemental oxygen
A patient has a decrease in heart rate from 80 to 50 bpm and a decrease in blood pressure from 140/90 to 60/40 mmHg while in the recovery room after adrenalectomy for pheochromocytoma. The most appropriate treatment is administration of
A 76-year-old man has a leaking abdominal aortic aneurysm. His blood pressure and pulse have remained stable for 15 minutes at 90/60 mmHg and 130 bpm, respectively. His hemoglobin concentration is 11 g/dl, and the EKG shows a left bundle branch block. Induction of anesthesia should proceed
(A) after a pulmonary artery catheter has been inserted and the pulmonary artery occlusion pressure is greater than 7 mmHg
(B) when the pulse has decreased below 130 bpm from the rapid transfusion of blood
(C) when systolic blood pressure has increased to more than 120 mmHg from the rapid infusion of lactated Ringer's solution
(D) immediately on arrival in the operating room
(E) when circulatory signs deteriorate or cease to improve with rapid volume expansion
An endobronchial Robertshaw tube is inserted for resection of a midesophageal tumor under isoflurane, oxygen, pancuronium anesthesia. Forty minutes into a planned two-hour resection, arterial blood gas values are reported as PO2 45 mmHg, PCO2 45 mmHg, and pH 7.33. Ten minutes earlier, the values were PO2 210 mmHg, PCO2, 41 mmHg, and pH 7.39. The first action should be to
(A) reposition the Robertshaw tube
(B) apply positive end-expiratory pressure to the ventilated lung
(C) reinflate and ventilate the non ventilated lung