Additional Key Terms

Question 1

When placing a pt in lateral decubitus position for nephrectomy, which part of the pt’s body should be over the kidney rest?

Answer 1

Pelvic bone –no ribs or soft tissue

Question 2

What pharmacologic adjunct can be added to LA to permit a higher does of LA to be administered without risk of side effects?

Answer 2

epi

Question 3

Immediately following administration of neuraxial anesthesia what blockade occurs at the highest dermatome level?

Answer 3

sympathetic (autonomic)

Question 4

Rank the order of the following LA for longest to shortest duration of action for epidural anesthesia.

bupivicaine, lidocaine, mepivicaine, chloroprocaine

Answer 4

bupivicaine
mepivicaine
lidocaine
chloroprocaine

Question 5

A 34 yo underwent a whipple is receiving epidural analgesia (bupi 0.1%, meperidine 0.1%) in PACU for postop analgesia but is requiring repead doses of phenylephrine to maintain blood pressure. What is the best course of action to take regarding pain management and epidural?

Answer 5

drop bupi rate and continue with hydromorphone

Question 6

What level should epidural catheter be placed for upper abdominal surgery?

Answer 6

T5 - T6

Question 7

How long should surgical anesthesia be expected to last with a Bier block?

Answer 7

1 hr

Question 8

What treatment drug/dose/route should be employed to treat hypotension that occurs within the first few minutes after the administration of spinal anesthesia?

Answer 8

5 mg ephedrine

Question 9

What are the most common sizes of spinal needles used?

Answer 9

25
27
22

Question 10

For epidural anesthesia, which LA would have the quickest onset?

Answer 10

chloroprocaine

Question 11

Which surgical position would be appropriate for administration of a hypobaric spinal anesthetic?

Answer 11

jackknife

Question 12

What is the advantage of an awake TURP?

Answer 12

assessing neuro status

Question 13

How much LA is used in a Bier block?

Answer 13

50cc

Question 14

For tetracaine spinal, what can be added to LA to prolong duration of the spinal anesthetic?

Answer 14

epi

Question 15

To perform a peripheral nerve block, what should the initial current setting be for the nerve stimulator?

Answer 15

0.25 mAmp

Question 16

Which LA has the most rapid onset for spinal?

Answer 16

lidocaine

Question 17

What is the max volume of bupivicaine 0.25% with epi 1:100,000 that can be safely infiltrated beside a surgical incision?

Answer 17

3 mg/kg

Question 18

During spinal anesthesia, what physiological mechanism produces the bradycardia that precedes asystole?

Answer 18

cardiac accelerator fibers

T1-T4

Question 19

What fluid management is employed during the early part of the case for cadaveric renal transplantation?

Answer 19

volume loading to get CVP from 7-8 –> 15 with 2 to 3 liters

Question 20

During lap chole, a pts end tidal CO2 increases to 48 mmHg at which time an arterial blood gas is obtained. PaO2 = 84mmHg, PaCO2 = 64 mmHg, pH = 7.28. What is the most likely cause of pt’s hypercapnia?

Answer 20

Increased alveolar deadspace ventilation