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2-General Anesthesia Exam 2 > Charts > Flashcards

Charts Flashcards

1
Q

Spinal dermatomes: C5 _________

A

Clavicles

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2
Q

Spinal dermatomes: C6 ________

A

Thumb

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3
Q

Spinal dermatomes: C6, 7, 8 __________

A

Hand

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4
Q

Spinal dermatomes: C8 ____________

A

Ring and little fingers

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5
Q

Spinal dermatomes: T4 __________

A

Nipples

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6
Q

Spinal dermatomes: T10 __________

A

Umbilicus

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7
Q

Id the size and function for the following fiber:

B

A

<3 microns

Fx: Preganglionic, sympathetic

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8
Q

Id the size and function for the following fiber:

C

A

.3-1.3 microns

Fx: Temperature, dull pain

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9
Q

Id the size and function for the following fiber:

A-delta

A

1-4 microns

Fx: temperature, sharp pain

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10
Q

Id the size and function for the following fiber:

A-gamma

A

3-6 microns

Fx: muscle spindle, muscle tone

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11
Q

Id the size and function for the following fiber:

A-beta

A

6-22 microns

Fx: Light pressure, touch

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12
Q

Id the size and function for the following fiber:

A-alpha

A

6-22 microns

Fx: somatic motor, proprioception

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13
Q

What are the containdications or comments for antiplatelet medications?

  • ticlopindine
  • clopidergrel
  • GP IIB/IIIa inhibitors
  • Tricagrelor
  • psrasugrel
  • what medications must be delayed after epidural removal? (3) Whats the delay time?
A
  • NSAIDS: No contraindication
  • Discontinue ticlopindine 14 days, clopidergrel 7 days, GP IIB/IIIa inhibitors 8-48 hr in advance
  • Tricagrelor: 5-7 days, psrasugrel 7-10 days
  • Epidural removal: 6-24 hours dleay until restarting tricagrelor, prasugrel and clopidogrel
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14
Q

What are the containdications or comments for unfractionated heparin subq medications?

A
  • No contraindication with twice daily dosing and total daily dose <10,000
  • consider delaying heparin until after block if technical difficulty anticipated
  • the safety of neuraxial blockade in patients receiving doses >10,000 units/day of UFH or more than twice daily dosing of UFH has not be established
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15
Q

What are the containdications or comments for unfractionated heparin IV medications?

A
  • Heparinize 1 hour after neuraxial technique
  • Remove catheter 2–4 hours after last heparin dose
  • No mandatory delay if traumatic insertion
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16
Q

What are the containdications or comments for LMWH medications?

A
  • Twice-daily dosing: LMWH 24 hours after surgery, regardless of technique
  • Remove epidural catheter 2 hours before first dose of LMWH
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17
Q

What are the containdications or comments for Warfarin medications?

A
  • Normal INR (before neuraxial technique)

- Remove catheter when INR ≤ 1.5 (initiation of therapy)

18
Q

What are the containdications or comments for fonaparinux medications?

A
  • Single injection, atraumatic needle placement or alternate thromboprophylaxis
  • Avoid indwelling catheters
19
Q

What are the containdications or comments for direct thrombin inhibitors medications?

A
  • ASRAPM: Insufficient information; suggest avoiding neuraxial techniques
  • Belgian and German Societies: Needle placement 8–10 hours after dose; delay subsequent doses 2–6 hours after needle placement
20
Q

What are the containdications or comments for thrombolytics medications?

A

Absolute contraindication

21
Q

What are the containdications or comments for herbal therapy?

A
  • No evidence for mandatory discontinuation before placement neuraxial technique
  • Be aware of potential drug interactions with the “3 Gs”: ginkgo biloba, garlic, and ginseng
22
Q

What are the containdications or comments for Factor Xa therapy?

A
  • Time between epidural anesthetic technique and next anticoagulant dose: rivaroxaban, 4–6 hours; apixaban, 6 hours
  • Time before last anticoagulant dose and epidural catheter removal: rivaroxaban, 22–26 hours; apixaban, 26–30 hours
  • Time between removal of epidural catheter and next anticoagulant dose: rivaroxaban and apixaban, 4–6 hours
23
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of 2-Chloroprocaine?

A

Conc: 2%-3
Onset: 10-15 min
Plain: 45-60 min
1:200,000 epinephrine: 60-90 min

24
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of lidocaine?

A

Conc: 1.5%-2
Onset: 15 min
Plain: 80-120 min
1:200,000 epinephrine: 120-180 min

25
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of mepivacine?

A

Conc: 1.5%-2
Onset: 15 min
Plain: 90-140 min
1:200,000 epinephrine: 140-200 min

26
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of bupivacine?

A

Conc: .5-.75%
Onset: 20 min
Plain: 165-225 min
1:200,000 epinephrine: 180-240 min

27
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of etidocaine?

A

Conc: 1
Onset: 15 min
Plain: 130-200 min
1:200,000 epinephrine: 150-225 min

28
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of ropivacine?

A

Conc: .5% .75-1
Onset: 15-20 min
Plain: 140-180 min
1:200,000 epinephrine: 150-200 min

29
Q

What is the concentration, onset, plain duration and 1:200,000 epinephrine duration of levobupivacine?

A

Conc: .5% .75-1
Onset: 15-20 min
Plain: 150-225 min
1:200,000 epinephrine: 150-240 min

30
Q

What is the redosing concentration, time to two segment regression (min) and recommended time for top up from initial dose of 2-chloroprocaine?

A
  • Concentration: 3%
  • time to two segment regression (min): 45-75 Min
  • recommended time for top up from inital dose: 45 min
31
Q

What is the redosing concentration, time to two segment regression (min) and recommended time for top up from initial dose of lidocaine?

A
  • Concentration: 2%
  • time to two segment regression (min): 60-140 Min
  • recommended time for top up from inital dose: 60 min
32
Q

What is the redosing concentration, time to two segment regression (min) and recommended time for top up from initial dose of bupivacaine?

A
  • Concentration: .10
  • time to two segment regression (min): 180-260 Min
  • recommended time for top up from inital dose: 120 min
33
Q

What is the redosing concentration, time to two segment regression (min) and recommended time for top up from initial dose of ropivacine?

A
  • Concentration: .1
  • time to two segment regression (min): 180-260 Min
  • recommended time for top up from inital dose: 120 min
34
Q

Epidural: dose.

A

Dose is high (10-20mL)

35
Q

Epidural: onset.

A

slow (25-30min)

36
Q

Epidural: what is the neuromuscular blockade?

A

Dose not cause as significant a neuromuscular blockade

37
Q

Epidural: what is a positive indication of this?

A

Multiple dosing possible, Can be given along various points along the spinal column

38
Q

Spinal: dose.

A

Dose is low (1.5-2mL)

39
Q

Spinal: onset.

A

fast (5min)

40
Q

Spinal: what is the neuromuscular blockade?

A

Causes a significant neuromuscular blockade

41
Q

Spinal: what is the dose frequency?

A

Single dose

42
Q

Spinal: what is important about the location of spinal?

A

Can only be given at specific locations in the spinal column to avoid damaging the spinal cord

2-General Anesthesia Exam 2 (11 decks)

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