Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesiology 398 and 466 > Lecture 8 Intro to Analgesia Techniques Part 2 > Flashcards

Lecture 8 Intro to Analgesia Techniques Part 2 Flashcards

1
Q
  1. Sites of Action of Local Anesthetics in Pain Pathway
  2. How do they generally work?
A
  1. Inhibit Transduction & Transmission
  2. Block influx of sodium across cell membrane of nerve axons & inhibit conduction of action potentials
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. How long does lidocaine last if given locally
  2. Can you keep going lidocaine for pain?
  3. Which species should you not give iv?
A
  1. Quick onset, short duration (1-2 hrs)
  2. Need to remember Toxic dose so have to be careful not to give all
    • Dogs: 10mg/kg, Cats: 5mg/kg
  3. Cats => Do NOT give IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. How long is the onset for bupivicaine
  2. Duration?
A
  1. 20min (longer than lidocaine)
  2. 4-6 hrs (longer than lidocaine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Does bupivacaine have preservative in it?
  2. What mode can you not give it?
A
  1. preservative free**
    • Aseptic technique
  2. NEVER give Bupivacaine IV!!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drug can you give to help IV catheterization?

A
  • Local block of lidocaine with NaHCO3 (so it doesnt sting)
    • Aids in placement/success

↓ struggling, stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to do a Testicular block

A

–2.0mg/kg, divided into each testicle

–I do not block spermatic cord or use bupivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How to do an Incisional block

A
  • Wound infiltration involves injection of local anesthetic directly into surgical field or incision
  • simple, safe, inexpensive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Incisional block – Recommendations

A
  • Simple, inexpensive, little-no risk if performed correctly
  • Individual patient variation in pain threshold, need for additional analgesics, incisional pain
  • Perform incisional block pre-skin or pre-linea incision
  • (Savvas 2008) => Pre-operative incisional bupivacaine => significantly lower pain scores, ↓ additional analgesics compared to saline or PO incisional block
  • Use bupivacaine, repeat @ closure depending on time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are different nerves that can be blocked

A
  1. Dental*
    • Mandibular, infra-orbital, maxillary
  2. Retrobulbar*
  3. Femoral/Sciatic*
  4. Brachial plexus
  5. RUMM
  6. Digital
  7. Intercostal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drug do you usually use dental blocks

A
  • Bupivacaine
  • Additional 50% LA can be administered for infraorbital nerve block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When giving dental blocks what must you always do

A
  • Always calculate maximum cumulative dose:
  • **BEWARE OF CUMULATIVE LA DOSE LEVELS**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. How do you do a Mental Nerve Block
  2. What does it block?
A
  1. Middle mental foramen is largest of the three
    • Palpate mental foramen just ventral to rostral (mesial) root of 2nd premolar
    • Advance needle into opening of foramen in rostral to-caudal direction, slowly inject
    • Digital pressure over injection site for 30 to 60 seconds to ensure caudal diffusion into mandibular canal
  2. Anesthetizes all oral tissues rostral to 2nd premolar on infiltrated side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. What are the techniques of the mandibular (inferior alveolar) block?
  2. What does it anesthetize?
A
  1. Two techniques: extraoral & intraoral
  2. Anesthetizes the bone, teeth, soft tissue & tongue on infiltrated side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you do the Mandibular (Inferior Alveolar) – Extraoral Technique

A
  1. Palpable notch on ventral mandible cranial to angular process
  2. If notch cannot be palpated (cats, some dogs) select point on ventral mandible located on a vertical plane with lateral canthus
  3. Insert & advance needle dorsally along lingual aspect of mandible to midpoint between ventral & dorsal borders of mandible => mandibular foramen where inferior alveolar nerve enters mandibular canal
  4. Aspirate & slowly inject

Notes:

  • Finger placed inside mouth along mandible to palpate foramen & location of needle
  • Clinical tips: Keep needle close to mandible with bevel directed toward bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is a Mandibular (Inferior Alveolar) – Extraoral Technique done

A
  • Palpate mandibular foramen intra-orally on lingual surface of mandible
  • Needle advanced thru mucosa adjacent to foramen at level of last lower molar tooth
  • Needle directed ventro-caudal towards angular process of mandible
  • Aspirate & inject slowly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you do an infraorbital block

A
  • Palpate infraorbital foramen in maxilla dorsal to caudal root of upper 3rd premolar
  • Insert needle through buccal mucosa in caudal direction, advance needle to entrance of foramen
  • Aspirate & inject slowly
17
Q
  1. Infraorbital nerve blocks anesthetize what?
  2. What does the areas affected depend on?
A
  1. •Anesthetizes bone, soft tissue & teeth rostral to upper 4th premolar
  2. depends on degree of caudal diffusion of anesthetic agent
18
Q

Go over Infraorbital nerve anatomy

A
  • Infraorbital nerve is rostral continuation of maxillary nerve
  • Maxillary/infraorbital nerve gives off caudal superior alveolar nerve before entering canal =>
    • supplies maxillary 4th premolar & molars
  • Within canal it branches to middle superior alveolar nerves => innervate premolars
  • Rostral superior alveolar nerves branch just before exiting infraorbital canal to innervate canine & incisor teeth
19
Q

Maxillary Nerve Block anesthetizes what

A

bone, teeth, soft tissue & palate on infiltrated side

20
Q

Maxillary Nerve Block 3 techniques

A

•3 techniques – all involve blind placement of LA into pterygopalatine fossa:

–Maxillary Tuberosity

–Subzygomatic

–Infraorbital

21
Q

Maxillary Nerve Block anatomic landmarks

A
  • Blocked @ distal end before enters foramen
  • Nerve runs close to maxillary artery, ventral to ocular globe, zygomatic salivary gland & deep facial vein
22
Q

How do you do the Maxillary N. Block Intraoral/Maxillary Tuberosity approach

A
  • Palpate notch where zygomatic arch meets bone surrounding last upper molar
  • Insert needle directly adjacent to bone at this level
  • Keep needle perpendicular to hard palate
  • Advance needle dorsally to level just beyond root tips of last molar
  • Aspirate & inject slowly
23
Q

How do you do Maxillary N. Block Infraorbital approach intra-oral

A
  • Same as infra-orbital nerve block
  • Insert thin, long needle into infraorbital foramen to ~ level of medial canthus and/or ↑ volume LA injected
  • May be high risk of injury to neurovascular structures in canal
24
Q

What drugs do you use for Lumbosacral Epidural

A
  • Opioids (Morphine) and/or Local Anesthetics (bupivacaine) most common
  • Choice depends on desired action
    • Analgesia only => opioids
    • Anesthesia + Analgesia + motor =>
      • LA +/- opioids
25
Q
  1. Caudal (Sacrococcygeal) Epidural blocks what
  2. Is there motor function in the hind limbs?
A
  1. Provides anesthesia/analgesia to:
    • perineum, penis, urethra, colon & anus
    • Blocks pudendal, pelvic and caudal nerves
  2. No loss of motor function to hind limbs (dose dependent)
26
Q

Indications for a Caudal (Sacrococcygeal) Epidural

A

–Facilitate passage urinary catheter in blocked cats

–Perineal procedures

–Tail amputations

27
Q
  1. Where do you do the injection site for a Caudal (Sacrococcygeal) Epidural in a cat?
  2. dog?
A

caudal to end of spinal cord

  1. S1 in cats,
  2. L7 in dogs
28
Q

Why do epidurals caudal to end of spinal cord

A

–Lowers risk of:

  1. •cord damage/entering subarachnoid space
  2. •Exacerbating hypotension
  3. •Spreading infection or bleeding into to spinal canal
29
Q
  1. How long will epidurals last with lidocaine
  2. bupivacaine
A
  1. Lidocaine 2mg/kg (0.1-0.2 mL/kg)
    • Quick onset
    • Lasts 60 – 90 minutes
  2. Bupivacaine 0.5-1.0mg/kg (0.1-0.2mL/kg)
    • Onset ~15minutes?
    • Lasts 2 – 6 hrs*
  3. Use preservative free
30
Q

How do you do a Caudal (Sacrococcygeal) Epidural

A
  1. Performed under sedation or GA
  2. Sternal recumbency
  3. Palpate space between sacrum-Cd1 or Cd1-Cd2
  4. Clip hair, sterile prep, wear sterile gloves
  5. 25G, 1 inch needle (cats)
  6. Insert on midline @ 30 – 45⁰ angle
  7. ‘Hitting bone’ => too shallow or @ floor of vertebral canal
  8. Attach syringe, aspirate for blood

Anesthesiology 398 and 466 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions