Four and one-half hours after initiation of general anesthesia for a radical hysterectomy, a 65-kg patient has a heart rate of 90 bpm, blood pressure of 100/70 mmHg, pulmonary artery occlusion pressure of 9 mmHg, and cardiac output of 2.8 L/min. Urine output has been 20 ml over the last two hours. The most appropriate next step is
Alveolar and inspired anesthetic concentrations equilibrate more rapidly with nitrous oxide than with desflurane because nitrous oxide
A neurologically intact 48-year-old woman is scheduled for removal of a parietal lobe arteriovenous malformation. The relative risk for complete resection is to be determined by a test occlusion of the feeding artery. Which of the following intraoperative monitoring techniques is most appropriate for this test?
A 70-year-old man with mild hypertension and aortoiliac occlusive disease is undergoing aortofemoral bypass grafting. Which of the following interventions is most effective in maintaining renal perfusion during infrarenal aortic clamping?
An 18-year-old woman has knee pain during arthroscopy performed with femoral and sciatic nerve blocks for repair of a torn medial meniscus. The most appropriate management is addition of which of the following nerve blocks?
A 35-year-old patient with asymmetric septal hypertrophy (IHSS) is undergoing bladder suspension with sevoflurane 1%, nitrous oxide 50%, and oxygen 50%. Immediately after skin incision, blood pressure decreases to 90/60 mmHg and junctional tachycardia of 150 bpm is noted on the ECG. Which of the following is the most appropriate management?
A 60-kg, 70-year-old man requires open reduction and internal fixation of an intertrochanteric fracture sustained 24 hours ago. Serum creatinine concentration is 1 mg/dl and blood urea nitrogen concentration is 40 mg/dl. The most likely cause of these findings is
Nitrous oxide is contraindicated during
Following maternal epidural injection, fetal exposure to chloroprocaine is lower than fetal exposure to bupivacaine for which of the following reasons?
Upon removal of the epidural catheter after uneventful labor and delivery in a 25-year-old primiparous woman, approximately 1.2 cm of the Teflon catheter is left behind in the epidural space. The patient is informed of the complication. The most appropriate management is