BCA Postoperative Pain Management 2

Question 1

Which opioid analgesic is most appropriate for patients with renal failure in the postoperative setting?

Accepted Answer

Fentanyl

Answer

Fentanyl is preferred in renal failure because it lacks active metabolites that accumulate with impaired clearance.

Question 2

What is the primary mechanism by which gabapentin reduces postoperative pain?

Accepted Answer

Blocking voltage-gated calcium channels

Answer

Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels, reducing excitatory neurotransmitter release.

Question 3

A patient on chronic buprenorphine therapy undergoes elective surgery. Which perioperative analgesic strategy is most appropriate?

Accepted Answer

Continue buprenorphine and supplement with higher-dose full opioid agonists as needed

Answer

Current evidence supports continuing buprenorphine perioperatively and using higher doses of full agonists to overcome partial agonist competition at mu receptors.

Question 4

Which route of ketorolac administration produces equivalent systemic analgesic efficacy to intravenous administration?

Accepted Answer

Oral

Answer

Oral ketorolac achieves similar systemic plasma concentrations and analgesic effect as intramuscular or IV routes at equivalent doses.

Question 5

The concept of 'preemptive analgesia' is based on preventing which neurophysiological phenomenon?

Accepted Answer

Central sensitization from nociceptive input

Answer

Preemptive analgesia aims to block afferent nociceptive signals before incision to prevent central sensitization and 'wind-up'.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Postoperative Pain Management 2