WorksheetsAcute Pain Management
Total questions: 10
Worksheet time: 20mins
Tissue damage causes inflammation, which releases chemical substances at the site of injury. Which of the following chemical substances causes pain?
Enkephalins
Prostaglandins
Na
Ca
Endorphins
Data that should be collected by inspection EARLY in the physical examination includes:
Observations of facial expression
The patient’s comments regarding weakness
Results of upper- and lower-extremity reflexes
Skin texture at the sites of sympathetic dystrophy
History of limitation of activity due to painful disorders
Which of the following groups of patients are at risk for inadequate measurement?
Elderly
Pediatric
Burn patients
Low back pain patients
All of the above
What the purpose of the psychological evaluation is NOT:
To determine the current status of pain sensations, cognitions, pain behavior and mood
To assess environmental factors that influence pain
To assess the premorbid personality function
To determine if the pain is psychogenic or organic
To assess the factors that can influence a patient’s response to treatment
In acute pain therapy, when one selects an analgesic agent, the choice is:
Fewer repeated doses of high-clearance drug
Fewer repeated doses of low-clearance drug
Frequent repeated doses of low-clearance drugs
Oral administration
Route where drug is administered to have direct access to receptors
Segmental epidural analgesia mandates placement of an epidural catheter at sites adjacent to dermatomes covering the field of pain. This reduces dose requirements while increasing the specificity of spinal analgesia. Suggested interspaces for thoracic surgery are:
T9 - T11
T2 - T8
C6 - T1
T12 - L2
T2 - L2
The side effects of IV local anesthetic are related to CNS toxicity. Early signs are all of the following EXCEPT:
Metallic taste
Tinnitus
Increased appetite
Agitation
Confusion
Patient-controlled epidural analgesia (PCEA) is indicated for patients with all of the following EXCEPT:
Intraabdominal surgery
Diagnostic arthroscopic surgery
Major thoracic surgery
Major orthopedic surgery
Liver transplant surgery
A 52-year old man who just had a gastrectomy under GA complained of severe pain in the RR. Vital Signs: BP 100/60, HR 110, RR 26/min. What is the most appropriate next step?
Intravenous morphine should be given in 2 mg increments until there is pain relief.
Patient-controlled analgesia should be started with morphine 2mg as a bolus dose, and a lockout interval of 10 minutes
Fentanyl 100mcg in 5ml saline should be injected through the epidural catheter and the epidural infusion started
Bupivacaine 0.1% should be added to the epidural infusion.
Give another dose of IV NSAID of choice.
The therapeutic advantage of continuous epidural infusion over intermittent bolusing is all of the following, EXCEPT:
Ease of titration
No tachyphylaxis
Steady-state concentration
Increased local anesthetic concentration
Provides uniform levels of analgesia while reducing the incidence of side effects.
