Arab Board Anesthesia Final Clinical and Oral Exam

Practice session

During general anesthesia maintained with sevoflurane and rocuronium for an open cholecystectomy, the anesthesiologist notices an unexplained progressive rise in end-tidal CO2 from 38 to 72 mmHg over 10 minutes despite doubling minute ventilation. The patient develops sinus tachycardia (135 bpm), jaw muscle rigidity, and body temperature increases from 36.8°C to 38.9°C. What is the definitive initial medication and recommended dose?

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