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Which of the following is a major advantage of using IV opioids to reduce the
amount of volatile anesthetic administered during thoracic surgery?

a) Decreased postoperative Ileus

b) Decreased risk of postoperative respiratory depression and atelectasis

c) Preservation of hypoxic pulmonary vasoconstriction

d) Maintenance of sympathetic nervous system responses

e) Decreased need for neuraxial anesthesia


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==Answer==
Answer c. 

Hypoxic pulmonary vasoconstriction is largely responsible for the
mammalian ability to maintain normal arterial oxygen saturation via
optimization of V/Q matching. All inhalational anesthetics blunt this response
(although isoflurane may cause less inhibition), and opioids may allow for less
volatile agent and thus improved V/Q matching intraoperatively. Opioids also
blunt autonomic responses and are often used for this reason in patients with
high risk of myocardial ischemia. However, these agents do increase the risk of
ileus as well as respiratory depression and atelectasis in the postoperative period.
An alternative is neuraxial anesthesia, which optimizes both V/Q matching
intraoperatively and postoperative analgesia and pulmonary clearance.


==Notes==
<references />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.

==Keywords==
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