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VMS 4001 > Large Animal Loco-Regional Anaesthesia > Flashcards

Large Animal Loco-Regional Anaesthesia Flashcards

1
Q

What different drugs can be used in loco-regional anaethesia ?

A
  • Local anaestheticsq
  • Opioids
  • Alpha 2 agonists
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2
Q

Wha relevance of ionisation of tissue when admin of local?

A

how quick they bind depends on pH of drug/tissue
if pKa lower than 8.9 -> long time to action

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3
Q

What determinants of duration of action ?

A
  • Protein Binding
  • Vasomotor Activity
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4
Q

Explain protein binding?

A

Inc protein binding -> slower systemic uptake -> longer duration of action

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5
Q

Vasomotor Activity - explain

A

Most locals cause some vasoD (exception: cocaine, bupivacaine, ropivicaine)

Vasodilation -> faster systemic uptake -> shorter duration of action

by adding vasoconstriction drug (e.g.epinephrine) will last longer because of slower systemic uptake

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6
Q

Describe toxicity with increasing dose of local?

A
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7
Q

which local in what species?

A
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8
Q

When would we use opioids?

A

Morphine (horses only)
- Epidural
- Intra-articular

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9
Q

Use of alpha 2 as local?

A

Xylazine or detomidine

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10
Q

What types of loco-regional anaesthetics ?

A

Topical
Local - around nerve or as a ring block/perinural
Regional - admin distant from surgical site creating whole anaesthetised region

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11
Q

What locations to consider in equine head ?

A
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12
Q

What locations in ruminants?

A
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13
Q

What Local areas for dehorning?

A
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14
Q

Castrate block?

A

Intra-testicular black

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15
Q

What is an example of regional block?

A

Epidural

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16
Q

What potential complications with epidural?

A

Inadvertent Intra-thecal Injection
Hypotension
Motor Block
Urinary Retention (morphine)
Neurological Injury
Drugs (e.g. preservatives, adrenalin)
Infection, Haematoma, Trauma

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17
Q

Where do we admin epidurals in ruminants?

A

Intracoccygeal epidural
Cattle and small ruminants
Co1-Co2

18
Q

What doses for intraoccygeal epidural?

A

Procaine 4 ml
Xylazine 1 ml

19
Q

Horse epidural location?

A

Co1 - Co2

20
Q

Horse Epidural doses?

A
21
Q

What other region for epidural?

A

Lumbosacral epidural L6-S1

22
Q

Doses for lumbosacral epidural ?

A

1ml/4.5kg BW
15ml for 70kg sheep

23
Q

Forelimb infiltrative nerve blocks?

A
24
Q

Hindlimb infiltrative nerve blocks ?

A
25
Q

Describe IV regional anaesthesia / Bier Block

A
  • Good restraint essential
  • Apply tourniquet
  • Inject approx. 20ml procaine 4%
  • Allow 10-15mins for full desensitization to occur
  • Allow min 20mins before removing tourniquet
  • Cattle and horses tourniquet can be left on for up to 2hrs
  • Provide good haemostasis
26
Q

Technique for retrobulbar block ?

A
  • 1 or 4 point technique
  • Inset needle percutaneously through eyelid, through conjunctiva or 3rd eyelid
  • 4-6” needle
  • 10-15ml procaine 5% + epinephrine
27
Q

Potential Complications - Retrobulbar block?

A
  • Globe Puncture
  • Increased IOP
  • Retrobulbar Haemorrhage
  • Subarachnoid Injection
  • Optic Nerve Trauma
  • Occulocardiac Reflex
28
Q

Anatomy landmarks for petersons block

A
29
Q

Technique for Peterson’s block?

A
  • Technically more difficult but less risky
  • Depression where caudal rim of orbit meets the
    zygomatic arch: rostral to the coronoid process of
    the mandable
  • 10cm needle aimed rostroventrally towards the
    point of the ‘cone’ made by the orbital contents
30
Q

Potential complications of Peterson’s block

A
  • Requires good knowledge of anatomy to reach
    correct site
  • IV injection
  • Blinking is prevented to eye vulnerable to
    dust/trauma
  • Keep out of bright light
31
Q

What techniques in order of increasing complexity can we do for a flank laparotomy?

A
32
Q

Line block advantages?

A
33
Q

Line Block Disadvantages?

A
34
Q

What does an inverted L block look like?

A
35
Q

Advantages of inverted L block?

A
  • Limited anatomical knowledge
  • Local proximal to surgery site
  • Easy to extend if block fails
  • Some Muscle relaxation
36
Q

Disadvantages of inverted L block?

A
  • Large volume of local
  • Time consuming
37
Q

What does a paravertebral block look like?;

A
38
Q

Liverpool technique for proximal paravertebral block?

A
39
Q

Cambridge technique for Proximal vertebral block?

A
40
Q

Advantages of paravertebral block?

A

Local distal to surgery site
Small volume of local
Good muscle relaxation
Reliably anaesthetises all layers of
body wall

41
Q

Disadvantages of paravertebral block?

A

Time consuming
Requires significant
anatomical knowledge
Difficult in well muscled and
fat individuals
Not easy to extend if fails

VMS 4001 (22 decks)

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