A 62-year-old man in the recovery room after inguinal hernia repair under general anaesthesia has blood pressure 185/105 mmHg and heart rate 98/min. He is grimacing and guarding his wound. He had no history of hypertension on preoperative assessment. The FIRST intervention should be:
- A Titrate intravenous fentanyl for pain ✓
- B Sublingual nifedipine
- C Intravenous labetalol
- D Oral clonidine
Correct answer: A. Titrate intravenous fentanyl for pain
Explanation
Pain is the most common cause of hypertension in the recovery room, and treating it with titrated opioid often normalises blood pressure without antihypertensives. Antihypertensive therapy is added only if pain is controlled and pressure remains elevated. Sublingual nifedipine is specifically discouraged because of unpredictable precipitous falls in pressure and reflex tachycardia, which can provoke myocardial ischaemia.
Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.