Practice Test Geeks(BCA) Board of Certification in Anesthesiology Practice Test
← All BCA Flashcard Decks

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

  1. Which landmark finding supports the use of systemic lidocaine infusions for postoperative analgesia after abdominal surgery?

    Answer: Decreased opioid consumption and earlier return of bowel function

    IV lidocaine infusions have been shown in RCTs to reduce postoperative opioid use and accelerate GI recovery after abdominal surgery.

  2. A patient with obstructive sleep apnea (OSA) is at highest risk for which opioid-related postoperative complication?

    Answer: Respiratory depression during sleep

    OSA patients have blunted hypercapnic and hypoxic ventilatory responses that, combined with opioid-induced respiratory depression, increase risk of apnea during sleep.

  3. Dexmedetomidine used as a postoperative analgesic adjuvant primarily reduces opioid consumption through which receptor mechanism?

    Answer: Alpha-2 adrenergic receptor agonism in the locus coeruleus and spinal cord

    Dexmedetomidine activates alpha-2 receptors centrally (locus coeruleus) and spinally (dorsal horn), producing sedation and opioid-sparing analgesia.

  4. When converting a patient from IV hydromorphone PCA to oral opioids at discharge, which equianalgesic conversion is most accurate?

    Answer: IV hydromorphone 1 mg = oral morphine 20 mg

    IV hydromorphone 1 mg is equianalgesic to approximately oral morphine 20 mg based on standard equianalgesic conversion tables.

  5. The serratus anterior plane (SAP) block is most appropriate for analgesia following which procedure?

    Answer: Breast surgery and chest wall procedures

    The SAP block targets the long thoracic nerve and lateral cutaneous branches (T2–T9), providing analgesia to the lateral chest wall and breast.

  6. Which physiological change in elderly patients most significantly alters opioid pharmacokinetics postoperatively?

    Answer: Reduced renal clearance and decreased plasma protein binding with increased free drug

    Elderly patients have reduced renal and hepatic clearance and lower albumin levels, increasing free opioid fraction and prolonging drug effect.

  7. According to ASRA guidelines, what is the minimum recommended interval between the last dose of low-molecular-weight heparin (prophylactic) and placement of a neuraxial block?

    Answer: 12 hours

    ASRA recommends at least 12 hours after prophylactic LMWH dosing before neuraxial block to minimize epidural hematoma risk.