Anesthesiology Flashcards
Local anesthesia blocks ___ sensations
Motor and sensory
LA blocks ___ channels intracellular or extracellular
Na channels
From outside to inside (intracellular)
Water soluble form
Ionized form
Carpules are made from what form
Water soluble to be in an injectable form
<7 ph - acidic = ____ inc or dec Hydrogen
> 7 ph - basic = ______
Increase
Decrease
Determines acidity of a compound
PKa
Low pka = ____ acidic or basic = more hydrogen or less
More acidic
More hydrogen
Lidocaine pKa
7.8
If tissue is acidic LA will be more or less effective
Less effective
More water sol
Order of loss of sensation
Si PaT nag ToPS
Pain Temp Touch Pressure Skeletal muscle tone
Anesthetic adverse rxns (2)
Toxicity
Allergies
Causes of toxicity (3)
Rapid induction of LA
vessel deposition
Overdosage
LA can cause allergic rxns due to (2)
Methylparaben
Sodium bisulfite
Management of Syncope
Tredelenburg
Maximum carpule for normal px
7
Preservative of LA
Methylparaben
Antioxidant of vasoconstrictor
Sodium bisulfite
Ester has highest incidence of LA allergic rxn due to ____
PABA metabolite - similar to methyl paraben
Effects of vasoconstrictor (3)
Inc duration of effect of LA
Reduce toxicity
Reduce bleeding
Max dosage of vasoconstrictor
0.2 g or 200 mcg
Max dosage of vasoconstrictors for cardiovascular compromised px
0.04 mg
40 mcg
All LA are vasodilators except
Cocaine
Brand name of lidocaine
Xylocaine
Lignocaine
Brand name of prilocaine
Citanest
Brand name of mepivacaine
Carbocaine
Brand name of bupivacaine
Marcaine
Brand name of etidocaine
Duranest
Brand name of articAine
Zorcaine
Septocaine
Short duration of action amide
3% mepicavaine
LA contraindi to kids
Bupivacaine
LA rapidly metabolized in he body
Articaine
Longest acting amides (2)
Bupivacaine Etidocaine (not available in the market)
Amide LA is combined to produce topical anesth
Lidoc
Priloc
Most common LA
Lidocaine
Amide safe for children and px with heart problems
Mepivacaine
Brand name of procaine
Novocaine
Brand name of benzocaine
Anbesol
Generic name of metycAine
Piperocaine
Brand name of piperocaine
Metycaine
Brand name of tetracaine
Dicaine
Needle lengths
Ultrashort - <20 mm
Short - 20 mm
Long - 32 mm
Needle dimension
30 g - small
27
25 g - large
Most common site of fracture of needle
Hub
Needle used for Md. block in pedia
27 gauge
Short needle
Needle used for mandiblock in adults
25/ 27 gauge
Long needle
Needle used for intralig injection
30 gauge
Short needle
Level of needle when mandiblock in children
Below occlusal plane 45degrees
Level of needle when mandiblock in adults
Parallel to occlusal line
Infraorbital block aka
True asan block
Infraorbital nerve block include ___ and ____
Asan - common
Msan - sometimes
Complication common of psan
Hematoma
Lesser palatine nerve aka
Post palatine nerve
Blocks ant 1/3 of hard palate
Nasopalatine nerve block
Nasopalatine nerve aka
Nerve of scarpa
Cyst seen in incisive foramen
Rx:_____
Nasopalatine duct cyst
Heart shape
Greater palatine nerve block aka
Anterior palatine n block
Gow gates blocks (5)
IAN Lingual n Auriculotemporal Mylohyoid n Long buccal
Closed mouth mandibular blocking
Akinosi vazirani technique
Gow gates blocking aka
True mandiblock