A 7-year-old, obese, 30-kg boy was anesthetized using an adult circle system containing a 3-liter bag and mask. Induction with nitrous oxide (2 liters), oxygen (1 liter), and enflurane 3% was characterized by three minutes of hyperventilation followed by apnea. Forty-five seconds later, the child moved and became difficult to control. The most likely cause of the movement is
(A) decreased alveolar concentration of enflurane during the period of apnea
(B) excessive uptake of enflurane by the child's fat
(C) higher fresh gas flows required with use of an adult circle system in a child
One hour after induction of anesthesia for a posterior fossa craniotomy using opioid, relaxant, and nitrous oxide, the brain begins to protrude through the dura. The most effective measure to decrease intracranial pressure is to
During surgery of the forearm under axillary block, a patient has pain in the lateral aspect of the forearm and responds by flexing the elbow. The most likely cause is inadequate block of which of the following nerves?
A patient receives 1.5% bupivacaine 40 ml and epinephrine 1:200,000 for axillary brachial plexus block for reduction of a forearm fracture. The tourniquet is inflated to 300 mmHg; 45 minutes later, the patient has pain that radiates to the posteromedial elbow. Which of the following nerves is NOT adequately blocked?