A 58-year-old male with hypertension and diabetes mellitus undergoes elective laparoscopic cholecystectomy under general anesthesia. Intraoperatively, 15 minutes after induction with propofol and intubation, the mean arterial pressure drops to 55 mmHg and SpO₂ falls to 88%. Which of the following is NOT a recognized cause of combined hypotension and hypoxia in this scenario?

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