Local Analgesia and Anesthesia Flashcards by Anika Eidson

What are the types of local anesthetic agents?

Ester-type local anesthetic agents

Amide-type local anesthetic agents

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What are the ester-type local anesthetic agents?

Procaine

Tetracaine

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What is the onset of action for procaine?

Rapid

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What is the duration of procaine?

Short

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What is procaine used for?

Infiltration

Regional blocks

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What is the onset of action for tetracaine?

Slow

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What is the duration of tetracaine?

Long

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What is tetracaine used for?

Topical anesthesia

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What increases the potency of a drug?

Increased lipophilic

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What are examples of amide-type local anesthetic agents?

Lidocaine
Mepivacaine
Bupivacaine

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What is the onset of action for lidocaine?

Rapid

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What is the duration of lidocaine?

Intermediate

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What is lidocaine used for?

Local blocks
Regional blocks
Antiarrhythmic (IV)

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What is the onset of action of mepivacaine?

Rapid

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What is the duration of mepivacaine?

Intermediate (> than lidocaine)

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What is mepivacaine used for?

Local blocks
Regional blocks
Intrarticular (horses-diagnostic)

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What is the onset of action of bupivacaine?

Intermediate

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What is the duration of bupivacaine?

Long

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What is bupivacaine used for?

Regional blocks
Epidural anesthesia/analgesia
Intraarticular analgesia (small animals)

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What are complications and toxicity of local anesthetic agents?

Local anesthetic overdose
IV administration
Cardiovascular and CNS toxicity
CNS excitation, depression, inconsciousness
Centrally mediated muscle contraction/seizures
Respiratory center depression = apnea
Peripheral vasodilation = hypotension
Decreased CO
Bradycardia
Ventricular fibrillation
Cardiac arrest
Allergic reaction
Methemoglobinemia
Tissue damage
Infection

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What is toxicity dependent on?

Potency

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What is topical anesthesia?

On theucous membranes

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What is used in topical anesthesia?

Tetracaine or lidocaine 2%
Avoid Benzocaine
Total dose <5 mg/kg

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What is used for infiltration anesthesia?

Lidocaine, Mepivacaine, or Procaine

Epinephrine

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What does epinephrine cause in infiltration anesthesia?

Prolongs block Ischemia Cardiac arrhythmias

What is used in regional anesthesia of the head?

Bupivacaine 0.5%; lidocaine 2% (0.1-0.2 ml per site) | Combine with sedation or general anesthesia

What is used for a brachial plexus block?

Bupivacaine 0.5% or Ropivacaine 0.5% +/- dexmedetomidine 0.5 μg/ml

What should a brachial plexus block be avoided in?

Conscious animals

What is used in sciatic and femoral nerve block?

Bupivacaine 0.5% or Ropivacaine 0.5% +/- dexmedetomidine 0.5 μg/ml

What should a sciatic and femoral nerve block be avoided in?

Conscious animals

What is used in IV anesthesia (Bier Block)?

Lidocaine 1% or 2%

What happens if an IV block is used for >90 minutes?

Ischemia, pain, sepsis

What is IV anesthesia used for?

Sutures or biopies, and digit amputation

What is used for an intraarticular block?

Bupivacaine (or Ropivacaine) 0.5% | Usually combine with opioids

What is used in a ring block?

Infiltration technique with lidocaine or bupivacaine

What is used in lumbosacral epidural anesthesia?

0.5% bupivacaine (0.1-0.2 ml/kg) +/- preservative free morphine 0.1 mg/kg

What does lumbosacral epidural anesthesia do?

Regional block of the spinal nerves

What is used in intrapleural and intercostal blocks?

Bupivacaine 0.5%

What do intrapleural and intercostal blocks do?

Pain management of thoracic injury or surgery

What is used in the auriculopalpebral nerve block in horses?

Lidocaine 2% or Mepivacaine 2%

What is auriculopalpebral nerve block used for in horses?

Motor block of the eyelids eye examination Corneal foreign body removal

What is used for a supraorbital nerve block in horses?

Lidocaine 2% or Mepivacaine 2%

What does a supraorbital nerve block do in horses?

Blocks motor and sensory innervation of the upper eyelid | Eye exam

What is used for an infraorbital nerve block in horses?

Lidocaine 2% of mepivacaine 2%

What does an infraorbital nerve block do in horses?

Sensory block of nostrils, roof of nasal cavity, maxillary sinus, upper lip, skin up to the medial canthus of the eye, upper teeth to the first molar Adjunct to general anesthesia for trephination of maxillary sinus and upper teeth extraction

What is used for a mental nerve block in horses?

Lidocaine 2% or Mepivacaine 2%

What is a mental nerve block used for in horses?

Sensory block of the lower lip | Rostrally to the mental foramen

What is used for a mandibular alveolar nerve block in horses?

Lidocaine 2% or Mepivacaine 2%

What is a mandibular alveolar nerve block used for in horses?

Mandibular alveolar nerve into the mandibular canal | Supplement to general anesthesia for lower incisors or premolar extraction

What is used for a retrobulbar ocular block in horses?

Lidocaine 2%

What is a retrobulbar nerve block used for in horses?

Adjunct to general anesthesia during eye surgery to prevent oculocardiac reflex

What is used for epidural anesthesia in horses?

Lidocaine 2% +/- xyalzine

Where is epidural anesthesia done in horses?

First coccygeal interspace

What are indications for epidural anesthesia in horses?

Surgery of the tail, perineum, rectum, vulva, vagina, inguinal region Obstetrical procedures Relieve tenesmus

What is used for proximal paravertebral thoracolumbar anesthesia in horses?

Lidocaine 2%

What is paravertebral thoracolumbar anesthesia used for in horses?

Standing exploratory lapratomy | Desensitizes spinal nerves T18, L1, and L2

What is used for a cornual nerve block in ruminants and swine?

Lidocaine 2%

What is a cornual nerve block in ruminants and swine used for?

Dehorning cattle and goats Cattle: cornual nerve block and infiltration of the caudal aspect of the horn Goats: Nerve block of cornual branches of zygomatocetemporal and infratrochlear nerve

What is used for a retrobulbar block in ruminants and swine?

Lidocaine 2%

What is a retrobulbar block used for in ruminants and swine?

Neuromuscular desensitization of the eye and eyelid | Enucleation, eye, or eyelid surgery

What is the peterson block used for in ruminants and swine?

Sensory and motor block of the eye

What is the ring block used for in ruminants and swine?

Infiltration around the limb

What is the indication for IV regional anesthesia in ruminants and swine?

Digit surgery

What is blocked with IV regional anesthesia in ruminants and swine?

Venous and arterial blood flow

What should be selected to use for IV regional anesthesia in ruminants and swine?

A superficial vein as distal as possible

What does proximal paravertebral thoracolumbar anesthesia do in ruminants and swine?

Desensitizes the spinal nerves T13, L1, and L2

What indicates a successful paravertebral thoracolumbar anesthesia technique?

Increased skin temperature and hemilateral scoliosis

What is the indication for line block anesthesia in ruminants and swine?

Flank laparotomy

What is the volume of anesthethic related to in line block anesthesia?

Incision length

Where is a caudal epidural done in cattle?

Sacrococcygeal of first interoccygeal space

What should be used in caudal epidurals in small ruminants and why?

Lidocaine 2% 1-2 ml to avoid prolonged paralysis