A 65-year-old woman with a medical history significant for tobacco use, hypertension, and laparoscopic cholecystectomy is brought to the operating room for a lumbar discectomy. She is placed in the prone position. General anesthesia is induced with propofol and rocuronium, and the patient is intubated without complications. Anesthesia is maintained with sevoflurane. Five minutes later, prior to incision, the ventilator sounds an alarm. Peak pressures have increased to 40 mm Hg, and end-tidal CO₂ has decreased from 30 to 20 mm Hg. Blood pressure is 90/60 mm Hg and pulse is 114/min. On examination, the patient is sedated and paralyzed. Heart sounds are rapid and regular. Bilateral wheezing is noted on auscultation of the lungs. What is the next step in management?

Question

A 65-year-old woman with a medical history significant for tobacco use, hypertension, and laparoscopic cholecystectomy is brought to the operating room for a lumbar discectomy. She is placed in the prone position. General anesthesia is induced with propofol and rocuronium, and the patient is intubated without complications. Anesthesia is maintained with sevoflurane. Five minutes later, prior to incision, the ventilator sounds an alarm. Peak pressures have increased to >40 mm Hg, and end-tidal CO₂ has decreased from 30 to 20 mm Hg. Blood pressure is 90/60 mm Hg and pulse is 114/min. On examination, the patient is sedated and paralyzed. Heart sounds are rapid and regular. Bilateral wheezing is noted on auscultation of the lungs. What is the next step in management?

Quizplus · Accepted Answer

The Answer is B

A 65-Year-Old Woman with a Medical History Significant for Tobacco