A woman with a type A dissection has been stabilized. What pharmacologic intervention should be considered next?

In the management of a type A aortic dissection, one of the critical aspects is addressing pain, as significant discomfort can lead to sympathetic stimulation, further increasing heart rate and blood pressure, which may exacerbate the dissection. Administering hydromorphone for pain management is an appropriate intervention, as it can provide effective analgesia and help decrease the body's stress response.

When considering pain management in the context of an aortic dissection, it is vital to maintain hemodynamic stability. While analgesics are crucial, they should be administered carefully, considering the patient's overall condition. Effective pain control can reduce the sympathetic drive, thereby potentially lowering heart rate and blood pressure, which are beneficial in the setting of a dissection, as they help minimize the risk of further tearing of the aorta.

In contrast, other options do not address the immediate concern of pain management or may not be the next appropriate step. For instance, fluid resuscitation might be needed in cases of significant hypotension or shock, but it is not typically prioritized in a stabilized patient with an aortic dissection. Initiating diltiazem might be relevant for rate control in certain cardiac scenarios, yet it is not standard practice in the early management of aortic