Anesthesia Pharmacology: Clinical Case-Autacoids

Anesthesia Pharmacology: Vasoactive Peptide Pharmacology Practice Questions

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A forty-eight year-old woman receives epidural anesthesia for vaginal hysterectomy.
In the recovery room, a fentanyl infusion was begun epidurally for relief of postoperative pain.
About six hours later, she began to complain of nausea and had two episodes of vomiting

case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
case editor: Michael Gordon, Ph.D.

What is the most probable cause of her nausea and vomiting?
1. unrelieved pain
2. peritoneal irritation
3. hypotension due to hypovolemia
4. emetic effect of fentanyl
How could the nausea and vomiting best be relieved?
1. discontinue the fentanyl infusion
2. sedate the patient with midazolam (Versed)
3. withhold oral administration of fluids
4. administer ondansetron