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Anesthesiology > Local Anesthetic Agents 3 > Flashcards

Local Anesthetic Agents 3 Flashcards

1
Q

What are 5 examples of blocks that can be used for local anesthesia of the flank?

A
  • Inverted L block
  • Incisional block
  • Epidural
  • Proximal paravertebral block
  • Distal paravertebral block
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2
Q

The objective of a proximal paravertebral block is to block which 3 nerves?

A

T13, L1, L2

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3
Q

Where is the site of needle insertion for a proximal vertebral block?

A

5 cm from midline and transversely in line between 2 dorsal spinous processes

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4
Q

What gauge and length needle is used for a proximal paravertebral block?

A
  • 16 or 18 g

- 12-15 cm

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5
Q

To block the ventral branch in a proximal paravertebral block, how much local anesthetic is given?
To block the dorsal branch?

A
  • 15 mL below intertransverse ligament

- 5 mL above ligament & leveled with dorsal surface of transverse processes

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6
Q

What are 4 advantages of a proximal block of infiltrative analgesia?

A
  • Wide & uniform area of analgesia & muscle relaxation
  • Incision site not disrupted
  • Infiltrative block may take 45 min to desensitize area
  • Faster technique
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7
Q

What are 4 disadvantages of a proximal block of infiltrative analgesia?

A
  • Technically difficult (obese cattle)
  • Scoliosis dye to back muscle paralysis (makes closure more difficult)
  • Vital structures (aorta & vena cava)
  • Loss of motor control in pelvic limb (caudal migration)
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8
Q

How do you find the site to give the first injection in a distal paravertebral block?

A
  • Find last rib then vertebrae just behind it.
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9
Q

Which 3 nerves are done in a distal paravertebral block?

Which nerve is purposefully skipped?

A
  • L1, L2, L4

- L3

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10
Q

How much local anesthetic is given in a distal paravertebral block?
How is it given?

A
  • 10-20 mls 2% lidocaine then withdraw needle short distance dorsal & caudal to transverse process & inject additional 5 ml
  • injected in a fan-shaped infiltration ventral to each process.
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11
Q

What are 4 advantages of a distal paravertebral block?

A
  • Lack of scoliosis
  • Lack of risk of penetrating major blood vessels
  • Minimal weakness in pelvic limb
  • Minimal ataxia
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12
Q

What are 2 disadvantages of a distal paravertebral block?

A
  • Larger doses of anesthetic

- Variations in efficiency (nerves may follow variable anatomic pathways)

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13
Q

What are 4 examples of equine cranial blocks?

A
  • Supraorbital
  • Auriculopalpebral
  • Infraorbital
  • Mental
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14
Q

Infraorbital nerve blocks provide anesthesia where?

What are 2 examples of indications for this?

A
  • Anesthesia of upper lip & nose

- Suturing of nasal laceration, placement of nose ring in cattle

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15
Q

Where does an infraorbital nerve block desensitize?

A

Entire anterior half of face from foramen rostrally.

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16
Q

How can you find the location to give an infraorbital nerve block in a horse?

A

Feel for the bony lip of the infraorbital foramen.

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17
Q

Where is the location of the infraorbital foramen?

A

1/2 the distance & 2.5 cm dorsal to a line connecting the nasomaxillary notch & rostral end of the facial crest.

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18
Q

Which muscle needs to be displaced when giving an infraorbital nerve block?

A

Levator nasolabialis muscle

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19
Q

Where is the injection given for an infraorbital nerve block?
How much anesthetic is used for a horse?

A

Perineurally at bony lip of infraorbital foramen using 10 mL of local anesthetic.

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20
Q

How do you locate the infraorbital foramen in cattle?

A

Rostral to facial tuberosity on a line extending from nasomaxillary notch to 2nd upper premolar

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21
Q

How much local anesthetic is given in cattle?

A

20-30 mL

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22
Q

What are 4 examples of what auriculopalpebral blocks are used for in horses and cattle?

A
  • Examination of eye
  • Treatment of eye
  • Foreign body removal
  • Minor ocular surgery
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23
Q

The blockade of the auriculopalpebral nerve causes what?

A

Akinesia of eyelids (loss of voluntary movement)

24
Q

Does an auriculopalpebral block desensitize the eyelids?

A

No, only paralyzes them.

25
Q

Where is an auriculopalpebral block given in a horse?

A

2.5 cm, 20 g needle inserted about 2 cm ventral to most dorsal point of zygomatic arch.

26
Q

How much local anesthetic is given in an auriculopalpebral block in a horse?

A

2.5 mL into dorsal border & another 2.5 mL as needle is withdrawn.

27
Q

Where is an auriculopalpebral block given in cattle?

A

Along dorsal edge of zygomatic arch. Feel groove about 5-7 cm caudal to notch formed by zygomatic arch & temporal process of malar.

28
Q

How much local anesthetic is given in an auriculopalpebral block in cattle?

A

5 mL

29
Q

What is the most commonly desensitized nerve in the head of a horse?

A

Supraorbital nerve

30
Q

What are 2 indications for a supraorbital nerve block?

A
  • Ophthalmic examination

- Anesthesia to upper eyelid

31
Q

What are 2 indications for Peterson & Retrobulbar blocks?

A
  • Enucleation of eyeball

- Removal of tumors from eye/eyelids

32
Q

Where is the point of injection for a Peterson technique block?

A

Notch formed by supraorbital process cranially, zygomatic arch ventrally, coronoid process of mandible caudally.

33
Q

What size needle is used for a Peterson technique block?

A

10 or 12 cm, 18 g

34
Q

What are 4 nerves blocked in a Peterson technique block?

A
  • Oculomotor
  • Trochlear
  • Abducens
  • Trigeminal
35
Q

What other type of nerve block must be done with a Peterson technique block?
Why?

A
  • Auriculopalpebral block

- Paralyze the eyelids

36
Q

What are 2 potential complications of a Peterson technique block?

A
  • Penetration of turbinates

- Injection into optic nerve meninges

37
Q

What are the sites of needle placement in a retrobulbar block?

A

Upper & lower lids or lateral & medial canthi. Deflect globe, insert into orbital apex until wall of bony orbit is felt.

38
Q

How is local anesthetic administered in a retrobulbar block?

A

Inject small increments as needle is advanced.

39
Q

What are 4 potential complications of a retrobulbar block?

A
  • Penetration of globe
  • Damage to optic nerve
  • Injections into meninges
  • Oculocardiac reflex
40
Q

What are 3 advantages to the Peterson technique block?

A
  • Safer & more effective
  • Less edema & inflammation
  • Minimized risk of orbital hemorrhage, penetration of globe, damage to optic nerve, risk of injection into optic
41
Q

What are 2 disadvantages to the Peterson technique block?

A
  • Requires more skill

- Does not paralyze eyelids without additional nerve block

42
Q

How many nerves are blocked in a cornual block in cattle?

In goats?

A
  • One

- Two

43
Q

Which nerve is blocked in both cattle and goats in a cornual nerve block?

A

Cornual branch of zygomaticotemporal

44
Q

Which nerve is blocked in goats but not in cattle in a cornual nerve block?

A

Cornual branch of infratrochlear

45
Q

An intravenous regional block is also known as what?

A

Bier block

46
Q

Can an intravenous regional block be used in a front leg, back leg or both?

A

Both

47
Q

Intravenous regional blocks are good for procedures not expected to take longer than what amount of time?
What are 2 examples of procedures?

A
  • 90 minutes

- Biopsies, small mass removals

48
Q

How is an intravenous regional block given?

A

Injecting local anesthetic IV after isolating the limb from rest of body by a tourniquet.

49
Q

How long is an intravenous regional block present?

A

As long as tourniquet is present.

50
Q

How does the local anesthetic get into the surrounding tissue with an intravenous regional block?

A

Diffuses through blood vessels into surrounding tissue.

51
Q

What should be given first before administering an intravenous regional block?

A

Sedation

52
Q

Where is the tourniquet placed?

A

Proximal or distal to elbow

53
Q

When should the tourniquet be removed and how?

A

Slowly within 90 minutes

54
Q

What are 2 vessels that can be used in the front leg of cattle for an intravenous regional block?

A
  • Dorsal metacarpal vein

- Radial vein

55
Q

Which vessel is used in the hind leg of cattle for an intravenous regional block?

A

Saphenous vein

56
Q

What is a block that may be used with castration?

Where is it administered?

A
  • Intratesticular block

- Directly into testicle

57
Q

What does not get desensitized with an intratesticular block?

A

Scrotum

Anesthesiology (19 decks)

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