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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.

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  1. Which postoperative pain assessment tool is most valid for patients who are intubated and unable to verbalize pain?

    Answer: Behavioral Pain Scale (BPS)

    The Behavioral Pain Scale (BPS) evaluates facial expression, upper limb movements, and compliance with ventilation in intubated patients unable to self-report.

  2. Clonidine added to a peripheral nerve block primarily prolongs analgesia through which mechanism?

    Answer: Activation of alpha-2 adrenergic receptors on peripheral nociceptors

    Clonidine activates alpha-2 adrenergic receptors on peripheral C-fiber nociceptors, hyperpolarizing them and reducing afferent pain transmission.

  3. A patient develops respiratory depression (RR 6/min) after epidural morphine. After administering naloxone, what is the most important next step?

    Answer: Monitor closely and repeat naloxone boluses or start a naloxone infusion

    Naloxone has a shorter half-life (30–90 min) than neuraxial morphine, so resedation is likely and repeated boluses or a continuous infusion are required.

  4. Which factor most increases the risk of persistent postsurgical pain (chronic pain after surgery)?

    Answer: Preoperative anxiety and pain catastrophizing

    Preoperative psychological factors including anxiety, depression, and pain catastrophizing are among the strongest predictors of chronic postsurgical pain.

  5. The erector spinae plane (ESP) block provides analgesia primarily by which mechanism?

    Answer: Diffusion of local anesthetic to the paravertebral space and dorsal rami

    Local anesthetic injected in the ESP spreads cranio-caudally and anteriorly, reaching the dorsal and ventral rami of spinal nerves via the paravertebral space.

  6. Methadone is advantageous for postoperative pain in opioid-tolerant patients primarily because it:

    Answer: Blocks NMDA receptors in addition to opioid receptors

    Methadone's NMDA antagonism helps reverse opioid tolerance and central sensitization, providing analgesia in patients unresponsive to other opioids.

  7. Which intraoperative intervention most reduces postoperative opioid consumption after laparoscopic cholecystectomy?

    Answer: Port-site infiltration with local anesthetic combined with IV dexamethasone

    Local anesthetic infiltration at trocar sites combined with dexamethasone (anti-inflammatory + PONV) provides multimodal opioid-sparing for laparoscopic cholecystectomy.