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**clinical survial guide > Anesthetics > Flashcards

Anesthetics Flashcards

1
Q

Chloroprocaine

trade name

A

Nesacaine

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2
Q

Chloroprocaine

onset

A

6-12 mins

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3
Q

Chloroprocaine

duration of action

A

0.5-1 hr

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4
Q

Chloroprocaine

max dose w/o Epi

A

800mg

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5
Q

Chloroprocaine

max dose w/ Epi

A

100mg

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6
Q

Procaine

Trade name

A

Novocaine

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7
Q

Procaine

onset

A

2-5 mins

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8
Q

Procaine

duration of action

A

1 hr

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9
Q

Procaine

max dose w/o Epi

A

750 mg

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10
Q

Procaine

max dose w/ Epi

A

1000 mg

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11
Q

Lidocaine

trade name

A

Xylocaine

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12
Q

Lidocaine

onset

A

3-5 mins

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13
Q

Lidocaine

duration of action

A

1.5-2 hrs

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14
Q

Lidocaine

Max dose w/o Epi

A

300 mg

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15
Q

Lidocaine

max dose w/ Epi

A

500 mg

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16
Q

Mepivacaine

trade name

A

Carbocaine, polocaine

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17
Q

Mepivacaine

onset

A

3-5 mins

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18
Q

Mepivacaine

duration of action

A

0.75-1.5 hrs

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19
Q

Mepivacaine

max dose w/o Epi

A

300 mg

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20
Q

Mepivacaine

max dose w/ Epi

A

not available

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21
Q

Bupivacaine

trade name

A

Marcaine, sensorcaine

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22
Q

Bupivacaine

onset

A

5 mins

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23
Q

Bupivacaine

duration of action

A

2-4 hrs

24
Q

Bupivacaine

max dose w/o Epi

A

175 mg

25
Q

Bupivacaine

max dose w/ Epi

A

225 mg

26
Q

Examples of esters (2)

metabolization?

A

Chloroprocaine, procaine

metabolized in blood by pseudocholinesterase

27
Q

Examples of amides (3)

metabolization?

A

lidocaine, mepivacaine, bupivacaine

metabolized by liver

28
Q

MOA of local anesthetics

A

anesthetic interferes with sodium and potassium currents in the nerve to inhibit depolarization and prevent signal transmission

29
Q

order of how nerve function is affected

A

pain > temp > touch > proprioception

30
Q

Why is epinephrine added to anesthetics?

A

causes vasoconstriction which decreases bleeding, shortens the onset of anesthesia, and prolongs effect by slowing the absorption

31
Q

conversion of concentration from % to mg

A

(% x 10) (# of mL used)

ex: 5 cc of 0.5% lidocaine = (0.5 x 10)(5)= 25mg of lidocaine

32
Q

examples of how a person can get systemic toxicity with local anesthetics (3)

A

inadvertent intra-arterial or IV injection
administration of excessive doses
rapid absorption from a highly vascular area

33
Q

symptoms of systemic toxicity of a local anesthetic

A

sensory disturbance, tongue numbness, twitching, vertigo, slurred speech, convulsions, hypotension, decreased cardiac output, cardiac collapse

34
Q

pts might have an allergic reaction to ____ in ___ local anesthetics

A

PABA

ester

35
Q

Hallux/digital blocks

A
  • used for procedures involving the hallux or other digits
  • types: Mercado (2 point), ‘V’, ‘H’, ring, triangle block
  • blocks adjacent proper plantar digital nerves and adjacent proper dorsal digital nerves
36
Q
  • used for procedures involving the hallux or other digits
  • types: Mercado (2 point), ‘V’, ‘H’, ring, triangle block
  • blocks adjacent proper plantar digital nerves and adjacent proper dorsal digital nerves
A

Hallux/digital blocks

37
Q

Mayo (ring) block

A
  • frequently used for bunion surgery
  • provides anesthesia proximal to the surgical site to preserve surgical tissue planes
  • targets: saphenous, deep peroneal, medial plantar, medial dorsal cutaneous nerves
  • may need to administer more local anesthetic at the distal interspace
38
Q
  • frequently used for bunion surgery
  • provides anesthesia proximal to the surgical site to preserve surgical tissue planes
  • targets: saphenous, deep peroneal, medial plantar, medial dorsal cutaneous nerves
  • may need to administer more local anesthetic at the distal interspace
A

Mayo (ring) block

39
Q

Ankle block

A
  • used for procedures distal to ankle
  • targets: tibial, saphenous, deep peroneal, superficial peroneal & sural
  • also in ring form (instead of targeting specific nerve sites)
40
Q
  • used for procedures distal to ankle
  • targets: tibial, saphenous, deep peroneal, superficial peroneal & sural
  • also in ring form (instead of targeting specific nerve sites)
A

Ankle block

41
Q

Tibial nerve (popliteal) block

A
  • used for TAL, gastroc recession, repain of Achilles tendon rupture, extensive clubfoot release
  • targets tibial nerve right after it branches from the sciatic nerve
42
Q
  • used for TAL, gastroc recession, repain of Achilles tendon rupture, extensive clubfoot release
  • targets tibial nerve right after it branches from the sciatic nerve
A

Tibial nerve (popliteal) block

43
Q

How is a tibial nerve block administered?

adult vs pediatric

A
  • adult pts should be prone with knee flexed 30 degrees, wheal administered 7 cm proximal to the popliteal crease and 1 cm lateral to the midline, between the tendons of semitendinosus and biceps femoris
  • pediatric pts may be supine if assistance is available to lift leg
44
Q

infiltration block

A
  • injection of anesthetic directly at the procedure site

- most frequently used in biopsy or excision of a lesion

45
Q
  • injection of anesthetic directly at the procedure site

- most frequently used in biopsy or excision of a lesion

A

infiltration block

46
Q

American society of Anesthetists Physical status classification (level 1-6)

A

1 - normal health pt
2 - pt with mild systemic disease
3 - pt with severe systemic disease
4 - pt with severe systemic ds that is a constant threat to life
5 - moribund pt who is not expected to survive w/o the operation
6 - declared brain-dead pt whose organs are being removed for donation

47
Q 
conscious sedation
(commonly used med and dose)
A

drug-induced depression or consciousness, during which pts continue to respond to physical and verbal stimuli

48
Q

goal of conscious sedation

A

relieve anxiety and relax pt w/o depressing consciousness to the point that the airway is compromised

49
Q

MAC

A

(monitored anesthesia care)
similar to conscious sedation, but pts are more deeply sedated - they are not easily aroused, but still respond purposefully to repeated or painful stimulation
- able to administer local anesthetic at operative site w/o pt discomfort
- pt is comfortable, airway is maintained, vitals are continuously monitored
- short recovery time and reduced incidence of nausea

50
Q

conscious sedation

commonly used med and dose

A
  • IV sedation and an analegesic/amestic

2 mg IV midazolam and 2 mg IV morphine

51
Q

MAC

commonly used med and dose

A
  • 1-2 mg of IV midazolam, repeated as needed for sedation
  • 30-80mg bolus of IV propofol for induction, then 25-100ug/kg/min for maintenance
  • 25-100ug of IV fentanyl by titration for analgesia
52
Q

general anesthetics

A

pt loses consciousness and ability to purposefully respond

53
Q

5 components of general anesthetics

A 
loss of consciousness
analgesia
amnesia
muscle relaxation
blunting of autonomic reflexes
54
Q

phases of general anesthetics

A

induction - pt goes from awake to unconscious, need adequate airway and ventilation
maintenance - unconscious state is continued for duration of surgery
emergence - awakening of pt

55
Q

general anesthetics

commonly used med and doses

A
  • combination of IV and inhalational agents
    induced with IV push of 2mg/kg propofol (150-200mg in most adults)
    maintained with isoflurane or sevoflurane, administered by vaporizer

**clinical survial guide (6 decks)

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