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7159 Surgery

A 32-year-old ex-heroin addict with hepatitis C requires an urgent laparotomy for Rx of a perforated duodenal ulcer. The patient is undergoing treatment with naltrexone. The results of pre-operative coagulation studies include an INR for the prothrombin time of 1.8 and a platelet count of 85,000/cubic mm. Given this scenario, which of the following post-operative analgesic techniques would be most appropriate?

ALocal anaesthetic-based epidural analgesia.
BKetamine patient-controlled analgesia
CIntramuscular Methadone
DFentanyl-based epidural analgesia
Surgery
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