Pain Management and Nerve Blocks MCQs

Anaesthesia · 16 free questions with answers & explanations.

1. A patient on long-term opioid therapy for chronic cancer pain requires escalating doses to maintain the same level of pain relief. This phenomenon is best explained by:
2. The mechanism of pregabalin as an adjunct in multimodal postoperative analgesia involves:
3. Thoracic epidural analgesia for major abdominal surgery provides superior analgesia compared to systemic opioids. Which specific physiological benefit beyond pain relief makes thoracic epidural the preferred analgesic for major open abdominal aortic aneurysm surgery?
4. An adductor canal block (ACB) is preferred over femoral nerve block (FNB) for total knee arthroplasty (TKA) because it achieves similar analgesia with which important functional advantage?
5. Transversus Abdominis Plane (TAP) block is performed under ultrasound guidance. Between which two fascial layers is the local anaesthetic deposited?
6. Intraoperative dexmedetomidine infusion reduces anaesthetic requirements through which receptor mechanism, and what is the unique pharmacological property that makes it distinct from clonidine?
7. Multimodal analgesia for major abdominal surgery typically includes paracetamol, an NSAID, and regional block. The 'ceiling effect' for paracetamol means that doses beyond the standard therapeutic range do not provide additional analgesia. The primary analgesic mechanism of paracetamol that is distinct from NSAIDs is:
8. Erector spinae plane (ESP) block is a newer fascial plane block. It provides analgesia primarily by local anaesthetic spreading to:
9. The recommended management of local anaesthetic systemic toxicity (LAST) presenting as cardiac arrest includes 20% lipid emulsion (Intralipid) bolus. The proposed mechanism by which lipid emulsion rescues cardiac toxicity from bupivacaine is:
10. A 55-year-old patient undergoes total knee replacement with spinal anaesthesia plus adductor canal block (ACB). Compared to femoral nerve block (FNB) for the same procedure, the primary advantage of ACB is:
11. Perioperative use of intravenous lidocaine infusion (1.5 mg/kg bolus then 1.5–2 mg/kg/hr) is increasingly used as part of multimodal analgesia. Which analgesic mechanism, beyond simple sodium channel blockade, is responsible for its anti-hyperalgesic effect?
12. Transversus abdominis plane (TAP) block provides analgesia by depositing local anaesthetic between which two muscle layers?
13. A patient with complex regional pain syndrome (CRPS) type I of the right lower limb has allodynia, oedema, and skin colour changes after a minor ankle sprain. Lumbar sympathetic block is being considered. Which feature DISTINGUISHES CRPS type I from CRPS type II?
14. Enhanced Recovery After Surgery (ERAS) protocols include multimodal analgesia. Which combination of analgesic techniques best reflects an ERAS multimodal approach for major colorectal surgery?
15. Which landmark or ultrasound-guided nerve block is most appropriate for analgesia following total knee replacement, sparing quadriceps strength for early rehabilitation?
16. Ketamine is used as an adjunct in chronic pain management. At sub-anaesthetic doses, what is its primary analgesic mechanism?