BCA Postoperative Pain Management 3

Question 1

What is the ceiling effect of buprenorphine most clinically relevant to in postoperative analgesia?

Accepted Answer

Respiratory depression plateaus at higher doses than analgesia

Answer

Buprenorphine's partial agonism means respiratory depression reaches a ceiling at subanesthetic doses, making it safer than full agonists in overdose.

Question 2

Which parameter best guides dose titration of patient-controlled analgesia (PCA) when a patient reports inadequate pain relief between PCA doses?

Accepted Answer

Increase the demand dose

Answer

Increasing the demand dose delivers more opioid per activation when baseline pain is undertreated between doses.

Question 3

A postoperative patient develops pruritus after intrathecal morphine. What is the first-line treatment?

Accepted Answer

Nalbuphine 5 mg IV

Answer

Nalbuphine, a mixed agonist-antagonist, reverses neuraxial opioid-induced pruritus without fully reversing analgesia.

Question 4

Celecoxib differs from ketorolac in the postoperative setting primarily because celecoxib:

Accepted Answer

Does not impair platelet aggregation

Answer

Celecoxib selectively inhibits COX-2 and does not inhibit COX-1-mediated thromboxane A2 production, preserving platelet function.

Question 5

Which nerve block is the most appropriate single regional technique for total knee arthroplasty analgesia that avoids motor blockade of the quadriceps?

Accepted Answer

Adductor canal block

Answer

The adductor canal block targets the saphenous nerve (sensory) within the canal, sparing the motor branches to the quadriceps that exit proximally.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Postoperative Pain Management 3