local anesthetic and conscious sedation

Question 1

propofol

Answer 1

conscious sedation
rapid onset, short duration
short context-specific 1/2 life
least hangover effect
hypotension and decreased resp

Question 2

midazolam

Answer 2

conscious sedation
short acting benzo with rapid onset
anxiolytic and amnestic
resp depression, less hypotension
reversed by flumazenil

Question 3

fentanyl

Answer 3

conscious sedation
short acting opioid with rapid onset
prolonged context-specific 1/2 life
depressed resp
reversed by naloxone

Question 4

remifentanil

Answer 4

conscious sedation
ultra short acting opioidmost often in infusion
short context-specifc 1/2 life (plasma esterase)
AE: chest rigidity and resp depression
reversed by naloxone

Question 5

ketamine

Answer 5

conscious sedation
NMDA receptor antagonist
dissociative anesthesia
minimal resp depression
indirect sympathetic stimulation (increased BP)
AE: sialorrhea and hallucinations

Question 6

dexmedetomidine

Answer 6

conscious sedation
alpha-2 agonist- similar to clonidine
minimal resp depression
some analgesia, anxiolytic
-most awake and comfortable
AE bradycardia and hypotension

Question 7

local anesthetic

Answer 7

topical: benzocaine, lidocaine, tetracaine
infiltration: lidocaine, mepivicaine
nerve block: lidocaine, mepivicaine
spinal block: bupivacaine, tetracaine
epidural: bupivacaine
caudal: lidocaine, bupivacaine