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Anaesthesia General anaesthesia 277e03ac

A 42-year-old woman presents for laproscopic gastric bypass. She weighs 191 kg and is 165 cm tall. She has history of hypeension, diabetes mellitus, obstructive sleep apnea, and acid reflux. Because of the sleep apnea, there is concern about mild pulmonary hypeension. Which of the following agent is most likely to produce the most rapid emergence in this patient

A
Isoflurane
B
Sevoflurane
C
Desflurane
D
Nitrous oxide
High-Yield Explanation
Desflurane has the lowest blood:gas paition coefficient of all agents listed. In addition, desflurane has a lower fat:blood solubility, which may help in this case because of the patient's morbid obesity. Under usual circumstances, nitrous oxide could be used in combination with desflurane; however, in this situation, nitrous oxide is contraindicated since the patient likely has pulmonary hypeension.

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