Society for Pediatric Pain Medicine
Better Care for Children in Pain

{“questions”:{“l8xg3”:{“id”:”l8xg3″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 30kg 8-year-old male with a history of Wilms tumor s\/p right nephrectomy at age 5, postoperative nausea and vomiting (PONV), and burning chronic post-surgical pain (CPSP) at right abdominal incision site with numbness, presents for an elective outpatient umbilical hernia repair. The patient had been requiring opioids and gabapentin for his pain until 8 months ago when it resolved. The anesthetic plan includes preoperative acetaminophen, a general anesthetic including 1mcg\/kg fentanyl, and post-induction, pre-incision bilateral rectus sheath blocks with 0.6mL\/kg of 0.2% ropivacaine with 1:200k epinephrine. Given the patient\u2019s history, which of the following preoperative medications is best suited to decrease postoperative pain and nausea \/ vomiting? “,”desc”:””,”hint”:””,”answers”:{“9x3dr”:{“id”:”9x3dr”,”image”:””,”imageId”:””,”title”:”A.\tKetorolac “},”b9d0o”:{“id”:”b9d0o”,”image”:””,”imageId”:””,”title”:”B.\tKetamine “},”je5ek”:{“id”:”je5ek”,”image”:””,”imageId”:””,”title”:”C.\tTramadol”},”2mnrq”:{“id”:”2mnrq”,”image”:””,”imageId”:””,”title”:”D.\tGabapentin “,”isCorrect”:”1″}}}},”results”:{“x65yr”:{“id”:”x65yr”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2025\/01\/SPPM-QOM-January-2025.pdf”}}}

{“questions”:{“yp0de”:{“id”:”yp0de”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 2-year-old child who weighs 15 kg, undergoes laceration repair of the right index finger in the operating room. The resident does a digital nerve block using 2% lidocaine with epinephrine (1:100,000) and uses 1 ml\/side. In the PACU, the anesthesiologists noticed the right index finger appeared pale and less perfused. Which of the following is the most likely cause of this finding?\t”,”desc”:””,”hint”:””,”answers”:{“3nihi”:{“id”:”3nihi”,”image”:””,”imageId”:””,”title”:”A.\tSurgical injury to artery”},”n1ebs”:{“id”:”n1ebs”,”image”:””,”imageId”:””,”title”:”B.\tUse of epinephrine in the block”,”isCorrect”:”1″},”8z957″:{“id”:”8z957″,”image”:””,”imageId”:””,”title”:”C.\tLocal Anesthesia Systemic Toxicity (LAST) “},”0zef3”:{“id”:”0zef3″,”image”:””,”imageId”:””,”title”:”D.\tHypothermia”}}}},”results”:{“hxeee”:{“id”:”hxeee”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/12\/SPPM-QOM-December-2024.pdf”}}}

{“questions”:{“6kzcc”:{“id”:”6kzcc”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 30-week gestational age 1-day-old neonate with moderate neonatal opioid withdrawal syndrome (NOWS) is in the NICU showing signs of agitation, poor feeding, and sleep disturbances. The pain service is consulted for nonpharmacologic recommendations to help with her symptoms. According to available literature, which of the following techniques are recommended as first line therapy for the treatment of NOWS?\r\n\r\n”,”desc”:””,”hint”:””,”answers”:{“l3emx”:{“id”:”l3emx”,”image”:””,”imageId”:””,”title”:”A.\tStart around the clock morphine “},”5nvw2”:{“id”:”5nvw2″,”image”:””,”imageId”:””,”title”:”B.\tPrescribe as needed acetaminophen and avoid opioids”},”wzvy1″:{“id”:”wzvy1″,”image”:””,”imageId”:””,”title”:”C.\tUse the eat, sleep, console approach”,”isCorrect”:”1″},”uu15q”:{“id”:”uu15q”,”image”:””,”imageId”:””,”title”:”D.\tProvide acupressure\/acupuncture prior to other therapy”},”rvdl0″:{“id”:”rvdl0″,”image”:””,”imageId”:””,”title”:”E.\tPlace a clonidine patch and recommend as needed morphine”}}}},”results”:{“huuxx”:{“id”:”huuxx”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/11\/November-2024-QOM.pdf”}}}

{“questions”:{“sfhwf”:{“id”:”sfhwf”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 16-year-old nulliparous female presents to the pain clinic for discussion of pain management options around placement of an intrauterine device (IUD) for contraception. She has seen the videos on TikTok(1) and is anxious about the potential discomfort during the procedure. She has no significant medical history and is not currently taking any medications. Vital signs are stable. Which of the following is the most effective analgesic technique for pain relief during the procedure?”,”desc”:””,”hint”:””,”answers”:{“7twn4”:{“id”:”7twn4″,”image”:””,”imageId”:””,”title”:”A. No pain management required”},”jr2uw”:{“id”:”jr2uw”,”image”:””,”imageId”:””,”title”:”B. Ibuprofen and acetaminophen”},”uceym”:{“id”:”uceym”,”image”:””,”imageId”:””,”title”:”C. Paracervical block”,”isCorrect”:”1″},”ju5tx”:{“id”:”ju5tx”,”image”:””,”imageId”:””,”title”:”D. Pre-procedure anxiolytic”}}}},”results”:{“ufgbu”:{“id”:”ufgbu”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/10\/SPPM-QOM-October-2024.pdf”}}}

{“questions”:{“11wj3”:{“id”:”11wj3″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 17-year-old male with a history of degloving injury to his left lower extremity following a traumatic ATV accident who has undergone 3 separate reconstructive surgeries, complicated by ongoing burning pain to the left lateral leg\/foot. He presents to your clinic for preoperative evaluation preceding his last and most involved surgery. In addition to his home regimen (acetaminophen, celecoxib, amitriptyline, pregabalin, and sometimes oxycodone), his previous perioperative analgesic regimen included sciatic nerve blocks with indwelling catheters, scheduled ketorolac, and oxycodone and IV hydromorphone as needed for breakthrough pain. Despite this, his acute-on-chronic pain has been difficult to treat post-operatively, interfering with his sleep and recovery. \r\n\r\nYou discuss the option of adding a ketamine infusion to his regimen but the patient is hesitant about receiving ketamine, citing its association with a highly-publicized death of a celebrity. He tearfully describes knowing friends who became mentally altered temporarily after taking ketamine tablets obtained online. You would like to educate your patient about ketamine use in treating pain. \r\n\r\nWhich of the following statements is TRUE? “,”desc”:””,”hint”:””,”answers”:{“3h78o”:{“id”:”3h78o”,”image”:””,”imageId”:””,”title”:”A. Injectable ketamine is a treatment approved by the FDA for pain management.”},”6cuev”:{“id”:”6cuev”,”image”:””,”imageId”:””,”title”:”B. Research indicates that ketamine is highly efficacious in treating non-neuropathic pain conditions including fibromyalgia, cancer pain, ischemic pain, and migraine headaches.”},”o1qpu”:{“id”:”o1qpu”,”image”:””,”imageId”:””,”title”:”C. According to the 2018 ASRA guidelines, since ketamine is given at subanesthetic doses to treat chronic pain conditions, personnel in charge of its administration only require DEA licensure and ACLS training.”},”0faxz”:{“id”:”0faxz”,”image”:””,”imageId”:””,”title”:”D. Ketamine is a non-addictive \u201cstreet\u201d drug popular for its euphoric and sensory-heightening properties.”},”8uyy4″:{“id”:”8uyy4″,”image”:””,”imageId”:””,”title”:”E. Ketamine can be shipped to patients as oral and injectable forms when prescribed by a clinician with appropriate DEA prescribing privileges.”,”isCorrect”:”1″}}}},”results”:{“bv73h”:{“id”:”bv73h”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/09\/SPPM-QOM-September-2024.pdf”}}}