Local Anesthetic Properties

Question 1

Clinical Sequence of effects:

Answer 1

1. sympathetic block (vasodilation, warm)- c/b
2. Loss of pain and temperature- a delta
3. loss of proprioception- a gamma
4. loss of touch and pressure- a beta
5. motor - a alpha

Question 2

Absorption rate by type of block:

Answer 2

“I can please everyone but Suzie and Sally”

Intravenous, Tracheal, Intercostal, Caudal, Paracervical, Epidural, Brachial plexus, subarachoid, subcutaneous

Question 3

Onset

Answer 3

"MEL Beats The Crap out of Paul"
*Fast
Mepivacaine- 7.6
Etidocaine- 7.7
Lidocaine(prilocaine)- 7.9
Bupivacaine (ropivacaine)- 8.1
Tetracaine- 8.5
Chloroprocaine- 8.1 
Procaine- 8.9
*SLOW

Question 4

What LA onsets are fast, moderate, slow?

Answer 4

Fast: lidocaine, prilocaine, etidocaine, mepivacaine, CHLOROPROCAINE
Moderate: Bupivacaine and ropivacaine
Slow: Procaine

Question 5

What LA are highly potent

Answer 5

Those that are highly lipid soluble: Bupivacain, etidocaine, tetracaine
“ you BET your ass that fart is potent!”

Question 6

Order of potency:

Answer 6

POTENCY= LIPID SOLUBILITY
“Every Time Bert Reads Ladies Magazines, Carl Pukes”
E,T,B,R,L,M/C/P(procaine)

Question 7

PROTEIN BINDING:

Answer 7

HIGH/ long acting: Bupivivicaine (95%), Etidocaine, Ropivacaine, Tetracaine (BERT last long in bed)

Moderate: Lidocaine (65%), mepivacaine (75%)

Short: Procaine, Chloroprocaine

Question 8

In summary:
Potency =
DOA=
Onset=

Answer 8

Potency = lipid solubility
DOA= protein binding
Onset= pKa