Lecture 4 Intro to Local and Regional Anesthesia Flashcards

1
Q

What are the major classes of local anesthesia?

A

amide, ester

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2
Q

What is a local anesthetic?

A

a substance which reversibly inhibits nerve conduction when applied directly to tissues at non-toxic concentrations

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3
Q

What is the mechanism of action of local anesthetics?

A

Limit influx of sodium, therby limiting propagation of the action potential

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4
Q

Which local anesthetics are esters?

A

cocaine, chloroprocaine, procaine, tetracaine

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5
Q

Which local anesthetics are amides?

A

Bupivacaine, lidocaine, ropivacaine, etidocaine, mepivacaine

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6
Q

What are the signs of systemic toxicity of local anesthetics?

A

lightheadedness, tinnitus, seizures, CNS/cardiovascular collapse, and cardiac arrest

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7
Q

What is the treatment of systemic local anesthetic toxicity?

A

intralipid 20% 1.5 mL per kg initially then repeated or start infusion

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8
Q

Vasoconstrictors should not be used in which locations on the body?

A

fingers, toes,nose, ear lobes, and penis

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9
Q

What are the types of regional anesthesia?

A

topical, local/field, intravenous block (Bier block), peripheral (named) nerve, plexus, central neuraxial

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10
Q

What is an IV block used for?

A

any surgical procedure on an extremity

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11
Q

What are the major kinds of neuroaxial blocks?

A

subarachnoid (spinals) and epidural

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12
Q

For which neuroaxial block should you have cerebrospinal fluid return through the needle?

A

spinal block (subarachnoid)

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13
Q

What tissue layers are penetrated for an epidural block?

A

skin, subcutaneous, supraspinous ligament, interspinous ligament, ligamentum flavum

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14
Q

What are the potential complications of both a spinal or epidural block?

A

post-dural puncture headache (This would be an accident in the epidural block. You shouldn’t puncture the dura for this.), hypotension, bradycardia, cardiac/pulmonary arrest

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15
Q

Which requires a lower dose of local: epidural or spinal block?

A

spinal

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16
Q

Which can be performed at any spinal level of the spinal column: spinal or epidural?

A

epidural

17
Q

What dermatome is at the nipple line?

A

T4

18
Q

What dermatome is at the xyphoid process?

A

T6

19
Q

What dermatome is at the umbilicus?

A

T10

20
Q

What dermatome is at the anterior knee, medial foot?

A

L4

21
Q

What dermatome is at the lateral foot?

A

S1