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Initial Patient Presentation
A 36-year-old female is brought to the emergency department by her husband. She complains of acute abdominal pain in the right lower quadrant.

She receives subcutaneous 5-mg morphine. Despite the morphine, she describes persistent pain at level “8” on a 0 to 10 numeric pain assessment scale.

After further evaluation, a presumed diagnosis of right ovarian torsion is made; the gynecologist plans an emergent exploratory laparotomy.

Previous Medical History

  • History of heroin abuse, patient is on maintenance therapy
  • Chronic renal insufficiency (CRI; baseline creatinine, 4.2 mg/dL) secondary to nonsteroidal anti-inflammatory drug (NSAID) use

Past Surgical History

  • Appendectomy at age 22


  • Penicillin (rash as a child), NSAIDs

Current Medications

  • Buprenorphine/naloxone 8 mg daily, daily calcium carbonate, and multivitamins

A preoperative evaluation showed the following results:

Which of the following statements regarding perioperative anesthesia is FALSE?

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