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A 68-year-old female who has a history of hypertension was recently diagnosed with adenocarcinoma of the lung, status post video-assisted thoracoscopic wedge resection of the right lower lobe. Given the minimally invasive surgical approach and patient’s refusal for regional anesthesia, the procedure was conducted uneventfully using general anesthesia with a combination of fentanyl and hydromorphone for pain control. The patient was stable, somnolent, and comfortable upon arrival into the post-anesthesia care unit (PACU). However, after 30 minutes the patient becomes increasingly agitated with O2 saturation dropping to around 90% (respiratory rate is 18 breaths/min and shallow). The patient is poorly responsive to PACU nurses’ questioning. Which of the following is an UNLIKELY contributor to this patient’s postoperative delirium (POD)?

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