Patient history: A 65-year-old female, 5′3′′ tall, weighing 52 kilograms with a non-small cell carcinoma of the left upper lobe, presented for a staging mediastinoscopy and biopsy under general anesthesia. Her medical history was significant for hypertension, COPD, GERD, and hepatitis C. Preoperative laboratory evaluation values were all within normal limits. Procedure: Induction of anesthesia was performed with Propofol 150 mg, fentanyl 75 mcg, and rocuronium 50 mg. Desflurane provided anesthesia maintenance.
However, the procedure was uneventful, lasting 81 minutes. Anesthesiologic Intervention I: Following confirmation of 3 twitches via TOF monitoring, the patient received neostigmine 3 mg and glycopyrrolate 0.6 mg intravenously. Persistent fade assessed via visual estimation of the TOF response was still evident even 20 minutes after medication administration. An additional dose of…
