TY - CHAP M1 - Book, Section TI - Skeletal Muscle Relaxants A1 - Kruidering-Hall, Marieke A1 - Campbell, Lundy A2 - Katzung, Bertram G. A2 - Vanderah, Todd W. PY - 2021 T2 - Basic & Clinical Pharmacology, 15e AB - CASE STUDYAn 80-kg 35-year-old woman with a BMI of 32 is undergoing right knee surgery for a meniscus tear. The surgeon and the patient both request general anesthesia for the procedure. In addition to obesity, the patient has hypertension (treated with hydrochlorothiazide), insulin-dependent diabetes, and she takes an oral contraceptive pill. She has no known drug allergies. Her physical exam is remarkable only for obesity and a Mallampati class 3 airway (indicating extremely limited space from tongue base to roof of mouth and probable difficulty in intubating). Because of her diabetes and risk for delayed gastric emptying, you elect to use endotracheal intubation to protect her airway during the procedure.After induction of anesthesia with propofol, you administer a dose of rocuronium to achieve skeletal muscle relaxation and to facilitate endotracheal intubation. Once fully relaxed, you attempt direct laryngoscopy but are unable to visualize her airway. You make changes to the patient’s position, and use a different technique, but you are still unable to perform intubation.You switch back to bag/mask ventilation, but it has now become more difficult to achieve adequate tidal volumes. You decide to reverse the neuromuscular blockade and wake the patient. (1) What agents could be used to reverse the neuromuscular blockade? (2) What would be the most appropriate agent to use in this scenario? (3) What problems may occur with your chosen agent? SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1176972993 ER -