Post-Operative Pain

Question 1

What type of inhibitor is paracetamol?

Answer 1

COX 3 and prostoglandin

Question 2

What type of inhibitor is ibruprofen & diclofenac?

Answer 2

COX 1

Question 3

SE of ibuprofen & diclofenac?

Answer 3

GI upset
Bronchospasm
Renal failure

Question 4

What type of inhibitor is Parecoxib and Calecoxib?

Commonly used?

Answer 4

COX 2

In anaesthesia

Question 5

More or fewer SE than ibuprofen & diclofenac?

Answer 5

Less

Question 6

Side effects of strong opioids?

Answer 6

Resp. depression
Miosis
Reduced gastric emptying/urinary retention 
Decreased consciousness 
Hypotension 
Euphoria

Question 7

WHO pain ladder:

Pain intensity 0?

Answer 7

Paracetamol PRN

Question 8

WHO pain ladder:

Pain intensity 1?

Answer 8

Regular Paracetamol

Weak Opiod (e.g. codeine/tramadol) PRN
NSAID PRN

Question 9

WHO pain ladder:

Pain intensity 2?

Answer 9

Regular Paracetamol
Regular weak opiod
Regular NSAID

Strong Opiod (e.g. morphine, oxycodone, diamorphine) PRN

Question 10

WHO pain ladder:

Pain intensity 3?

Answer 10

Regular Paracetamol
Regular NSAID

Strong Opiod PRN

OR

Standard PCAS (patient controlled analgesia) epidural/single shot spinal

Question 11

Complications of spinal and epidural analgesia? (8)

Answer 11

Hypotension 
Respiratory depression
Sedation
Pruritis 
Urinary retention - Cather may be required
Numb/weak legs
Vertebral canal heamatoma 
Infection

Question 12

If patient is resiltess pos-op what must you always exclude first?

Answer 12

Urinary retention