Postoperative Pain Management Flashcards
7 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Postoperative Pain Management flashcards as text
Which opioid analgesic is most appropriate for patients with renal failure in the postoperative setting?
Answer: Fentanyl
Fentanyl is preferred in renal failure because it lacks active metabolites that accumulate with impaired clearance.
What is the primary mechanism by which gabapentin reduces postoperative pain?
Answer: Blocking voltage-gated calcium channels
Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels, reducing excitatory neurotransmitter release.
A patient on chronic buprenorphine therapy undergoes elective surgery. Which perioperative analgesic strategy is most appropriate?
Answer: Continue buprenorphine and supplement with higher-dose full opioid agonists as needed
Current evidence supports continuing buprenorphine perioperatively and using higher doses of full agonists to overcome partial agonist competition at mu receptors.
Which route of ketorolac administration produces equivalent systemic analgesic efficacy to intravenous administration?
Answer: Oral
Oral ketorolac achieves similar systemic plasma concentrations and analgesic effect as intramuscular or IV routes at equivalent doses.
The concept of 'preemptive analgesia' is based on preventing which neurophysiological phenomenon?
Answer: Central sensitization from nociceptive input
Preemptive analgesia aims to block afferent nociceptive signals before incision to prevent central sensitization and 'wind-up'.
Which adjuvant is most effective for reducing opioid requirements after spine surgery specifically?
Answer: Ketamine
Ketamine, an NMDA receptor antagonist, significantly reduces opioid consumption after spine surgery by blocking central sensitization.
Postoperative ileus following abdominal surgery is best prevented by which analgesic approach?
Answer: Thoracic epidural analgesia with local anesthetics
Thoracic epidural analgesia with local anesthetics reduces systemic opioid use and provides sympathetic blockade, both of which promote GI motility recovery.