Pain medicine

Question 2 (Sept 2019)

A 63 year old man has had an elective laparotomy and removal of intestinal tumour in an enhanced recovery setting. He has had a single shot spinal with an intrathecal (IT) opioid.


a) Name 3 other methods that could be used to control postoperative pain in this patient? (3 marks)

b) Describe the mechanism of action of IT opioids. (5 marks)

c) List 6 side effects of IT opioids. (6 marks)

d) Name 6 factors may increase the risk of postoperative respiratory depression following administration of IT opioids? (6 marks)

Question 9 (Mach 2019)


You are called to see a patient who has had a below knee amputation 24 hours ago. Despite using a PCA pump with IV morphine he is still in pain.


 a) State 6 reasons why his pain control may have become inadequate (6 marks)

b) Outline 6 ways you could re-establish optimal pain control (6 marks)

c) Name 3 features that would indicate this patient is suffering from post-amputation pain syndrome (phantom limb pain) (3 marks)

d) Name 5 other pharmacological options that are available for managing post-amputation pain syndrome (5 marks)

Question 2 (March 2018)


a) List 8 cases of pain in a patient with advanced cancer (8 marks)

b) Name 3 ways in which the side effects from opioid medications can be minimised in a patient with advanced cancer (3 marks)

c) Outline 6 pharmacological treatments used to relieve cancer pain (6 marks)

d) Outline 3 non-pharmacological treatments which are available to help relieve cancer pain (3 marks)