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Moving Exam 2 > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

1
Q

Types of regional anesthesia

A

Nerve pathway
- neuroaxial = epidural or spinal
- perinerual = brachial plexus block

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2
Q

Types of general anesthesia

A

Systemic /full body effect
Volatile (inhalants or injectables)

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3
Q

Types of local anesthetics

A

Topical - skin, mucosa (surface)
Infiltrative - line block, testicular (below surface)

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4
Q

Indications for LA and SA

A

LA - common w heavy sedation
SA - normally combined w general anesthesia
Monitor patients & provide oxygen

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5
Q

Goals for using local anesthesia

A

Reduces anesthesia requirements when combined w GA, reducing the GA side effects
^ cardio function
Better pain control

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6
Q

Sodium channel blockers

A

Not specific for pain pathways
Block transduction & transmission at site, regional or local
Affect modulation
Differential block - temp, sharp, light touch, motor

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7
Q

Forms of anesthetics targeting initial perception

A
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8
Q

Forms of anesthesia that block modulation of spinal pathway

A
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9
Q

Forms of anesthesia for blocking transmission

A
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10
Q

Forms of anesthesia for blocking transduction

A
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11
Q

Chemical compounds of local anesthetics

A

Benzene ring & hydrophilic amine group
- linked by amide or ester bond
Weak bases

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12
Q

Examples of aminoamides

A

Lidocaine, bupivacaine, mepivacaine, ropicavaine, prilocaine

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13
Q

Examples of aminoesters

A

Propaganda in, procaine, (novacaine) tetracain, benzocaine

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14
Q

Lidocaine common use

A

Most widely used in VM, small & large, short onset & duration of action, moderate tissue irritating

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15
Q

Bupivacaine common use

A

Longer onset & duration of action, most cardio toxic !! Second most commonly used
-consider post op analgesia effects

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16
Q

Mepivacaine common use

A

Common in horses, joint blocks, less irritating to tissues

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17
Q

Proparacaine common use

A

Ophthalmic preparations, short onset & duration

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18
Q

Factors effecting activity

A

PH at site of admin - low pH = low efficacious (cannot be in non ionized form, lower form of action)
Dose administered - better to ^ concentration than volume for prolonged action

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19
Q

Additives to local anesthetics

A

Sodium bicarbonate - reduces pain of injection
Vasoconstrictors - epinephrine- increased duration
Analgesics - opioids, alpha-2s

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20
Q

Toxicity of local anesthetics on cardio system

A

= high systemic contraction
Hypotension, arrhythmias (may be refractory) cardiac arrest

21
Q

Toxicity of LA on rest p

A

Hypoventilation to point of apnea or resp t arrest

22
Q

Toxicity of LA on CNS

A

Tremors or ataxia, sedation to coma, seizures

23
Q

Species sensitive to LA toxicity

A

Cats are more sensitive than dogs
Sheep are most sensitive in general

24
Q

Drugs to care for seizures from LA tox

A

Benzodiazepines

25
Q

Drugs to care for cardio from LA tox

A

IV fluids for hypotension,vasodilation, positive into ropes, anti cholinergic, vasopressors

26
Q

Ways to care for respt from LA tox

A

Supplemental ox, ventilation support

27
Q

Use & function of lidocaine

A

Can be given IV for systemic analgesia, given as CRI
- may decreased anesthetic requirements
Most commonly used in horses
- concern for sedation & ataxia in recovery
Prokinetic GI, anti-endotoxemic, anti inflammatory
-not recommended in cats bc of cardio depression

28
Q

Why is lidocaine a good option for a collcing horse?

A
29
Q

why is lidocaine IV not recommend for cats?

A

Very negative ionotropic effect in cats = decreased cardiovascular function

30
Q

Why are spinal needles preferred when performing an epidural ?

A
31
Q

What types of nerves are blocked in an epidural & spinal blocks

A

Sensory, motor and autonomic
Blocks motor function of both legs
Spinal /sciatic blocks - singular /effected legs

32
Q

Locations for epidurals

A

Lumbosacral or sacrococcygeal

33
Q

Lumbosacral block

A

Common in SA
Anesthesia of caudal ab, pelvic limb, perineum, tail

34
Q

Sacrococcygeal block

A

Common in LA could be SA
Avoids anesthesia of caudal Ab and pelvic limb
Want to avoid LA losing function of pelvic limbs

35
Q

Spinal cord ends in dogs & what block is common

A

L5-L6
Lumbosacral

36
Q

Spinal cord ends in cats & what block is common

A

S1-S2
Sacrococcygeal

37
Q

Spinal cord ends in pigs & what block is common

A

L6-S1
Sacrococcygeal

38
Q

Spinal cord ends in ruminants & what block is common

A

S3-S4
Sacrococcygeal

39
Q

Spinal cord ends in EQ & what block is common

A

S3-S4
Sacrococcygeal

40
Q

Areas effected with 0.1mL/kg of local

A

Perineum, tail

41
Q

Area effected by 0.2mL/kg of local

A

Pelvic limbs, perineum, tail

42
Q

Area effected with 0.3mL/kg

A

Caudal ab, pelvic limb, perineum, tail

43
Q

Risks w spinal

A

Spinal requires reduces dosage, (typically half of original) if volume is too high could lead to sympathetic blockage, vasoconstriction =hypotension

44
Q

CHAINS

A

Coagulopathy
Hypovolemia
Abnormal anatomy
Infection
Neoplasia
Sepsis

45
Q

Epidural tech

A

LA - standing
SA - recumbent, sternal (easier) or lateral
Clip & prepare area
Palpate wings of ilium to locate space between L7 and S1
Pierce skin, bevel faces cranially, “pop” or loss of resistance - enter space
ASPIRATE
Deliver slow

46
Q

hanging drop aspiration

A

Sucked if enters epidural space

47
Q

Complications encountered

A

Blood during aspiration
- withdraw entirely & restart
CSF during aspiration
- remove/restart OR reduce injection volume 50%
When sternal pull hind limbs cranially, aligns pelvis

48
Q

Additional pharmacologics

A

Analgesics- opioids, alpha 2 agonists
Prolonged compared to systemic admin
Lower doses, less side effects
Morphine is most common - alpha2 agonists more common in equine

49
Q

Other types of blocks & species commonly used

A

Dental blocks
TAP (transverse abdominis plane) ab body wall
Bier block - distal limb, more La than Sa
Teat block - cattle, sheep
Retrobulbar block - enucleation
Lidocaine topical - feline/swine larynx prior to intubation
Proparacaine - ocular procedure, nasal tube passage (small animal)

Moving Exam 2 (26 decks)

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