07-28-2011, 11:28 AM
10. A 34-year-old woman undergoes a middle ear operation with oral intubation and general anesthesia. During the 4-hour procedure she was in a semi-lateral position with her head maximally turned to the right and her chin tucked on her chest. She awakens normally at the end of the procedure and is extubated without difficulty. Approximately 30 minutes later she appears anxious and is sitting upright. She leans forward and says, "I'm not getting enough air." Her voice is barely audible and very hoarse and she appears to be struggling to take a deep breath. Vital signs are: pulse 94/min, respirations 28/min and blood pressure 128/72 mm Hg. Oxygen saturation is 92% with an FIO2 of 0.4. Oxygen flow is maximally increased and O2 saturation is 93%. Auscultation of the chest discloses bilateral breath sounds with crowing sounds on inspiration and expiration. Which of the following is the most appropriate pharmacotherapy?
A) Midazolam
B) Naloxone
[C) Nebulized racemic epinephrine]
D) Neostigmine
E) Succinylcholine
A) Midazolam
B) Naloxone
[C) Nebulized racemic epinephrine]
D) Neostigmine
E) Succinylcholine