Anesthesia Pharmacology:  General Anesthesia Clinical Case Questions

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  • A 29 year-old man was brought to the emergency room after a motor vehicle accident.

  •  He was in excruciating pain, requiring significant fentanyl (2.5 mg;Sublimaze) given as divided doses preoperatively.
    Laparotomy was acquired to repair a ruptured liver. Blood transfusions were necessary, but at the close of the procedure his circulatory values were normal.

  • His anesthesia was with thiopental (Pentothal), roncuronium (Zemuron), and nitrous oxide/isoflurane (Forane)/oxygen with fentanyl (Sublimaze) 10ug given just before induction, in the same dose during abdominal closure to minimize pain upon awakening.


  • However, when surgery was completed, he remained apneic after the inhalational agents were discontinued

  • case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
    case editor: Michael Gordon, Ph.D.