A patient undergoes differential spinal block for evaluation of persistent foot pain. If the pain returns coincident with a decrease in skin temperature, which of the following is the most appropriate conclusion?
A jaundiced patient requires general anesthesia for portocaval shunt. He has a long history of alcohol abuse and is cirrhotic with ascites. Special considerations relevant to induction of anesthesia for this patient include each of the following EXCEPT:
(A) Denitrogenation by mask may be more rapid than expected
(B) The risk of aspiration is increased
(C) The dose of thiopental necessary for induction will be predictably reduced
(D) The duration of succinylcholine action may be prolonged
(E) Alfentanil would be an appropriate supplement
C
Which of the following statements concerning the superior laryngeal nerve is true?
(A) It provides sensory innervation to the subglottic surface of the vocal cord
(B) It provides sensory innervation to the inferior surface of the epiglottis
(C) It is a branch of the glossopharyngeal nerve
(D) It is blocked by injection of anesthetic near the lateral portion of the cricothyroid membrane
(E) It is the most commonly injured nerve during thyroid surgery
A combined epidural and general anesthetic is used for aortofemoral bypass surgery. Just prior to extubation, the patient received morphine 5 mg through the epidural catheter. Eleven hours later, he is unresponsive while breathing 40% oxygen from a face mask. Respiratory rate is 6/min and SpO2 is 92%. Arterial blood gas analysis shows PaO2 80 mmHg, PaCO2 84 mmHg, and pH 7.16. Which of the following statements concerning this patient is true?
(A) Hypercarbia is contributing to the decreased level of consciousness
(B) Naloxone is ineffective for reversing the respiratory depression
(C) The oxygen saturation is higher than expected because of the pH
(D) The risk for respiratory depression would have been lower with subarachnoid administration of 0.5 mg morphine
(E) Residual local anesthetic is contributing to the respiratory depression
Which of the following inhalational anesthetics best relieves left ventricular outflow obstruction in a patient with hypertrophic obstructive cardiomyopathy (IHSS)?