Which of the following complications is more likely to occur during cannulation of the left internal jugular vein than during cannulation of the right internal jugular vein?
During isoflurane anesthesia, a 45-year-old patient with chronic asthma has wheezing, prolonged expiration, sinus tachycardia of 120 bpm, and premature ventricular contractions. Preoperative medication included cromolyn and theophylline. The most appropriate treatment is to administer
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
(A) administer thiopental
(B) decrease left ventricular afterload
(C) increase arterial blood pressure
(D) replace the left ventricular vent
(E) resume cardiopulmonary bypass
C
Which of the following statements about patient-controlled analgesia using opioids is true?
(A) It is not associated with respiratory depression
(B) It obviates loading doses
(C) It requires a background opioid infusion to be effective
(D) It requires intravenous administration to be effective
(E) It requires less drug than intramuscular dosing for similar analgesia
During anesthesia with nitrous oxide, oxygen, and a relaxant, the patient's lungs are being mechanically ventilated and there is a heated humidifier in the circuit. The most likely cause of an apparent increase in inspired oxygen concentration is
(A) a hole in the ventilator bellows
(B) backflow of fresh gas because of resistance in the humidifier
A patient who is scheduled for emergency debridement of an infected wound on the sole has trismus, rigidity of facial muscles, and spasms of the intercostal muscles, diaphragm, and extremities. During anesthesia, this patient is at increased risk for each of the following EXCEPT
(A) hypotension
(B) hypertension
(C) tachycardia
(D) diaphoresis
(E) hypothermia
E
A patient is undergoing cholecystectomy with enflurane, nitrous oxide, fentanyl, and oxygen. He takes theophylline and cromolyn sodium for bronchial asthma. During skin incision he has bilateral wheezing; peak inspiratory pressure is 50 cmHzO, and the ECG shows occasional premature ventricular contractions. The most appropriate management is to