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Intro To Nurse Anesthesia > Local Anesthetics and Regional Anesthesia > Flashcards

Local Anesthetics and Regional Anesthesia Flashcards

1
Q

Local anesthetics prevent depolarization of nerve by blocking _____

A

influx of NA, blocks fast NA channels

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2
Q

Which fibers are blocked easier by local anesthetics?

A

small fibers

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3
Q

Order of a Block:

A

B fibers
C
A-
delta, gamma, beta, alpha

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4
Q

Two types of locals:

A

esters and amides

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5
Q

Amides are cleared by reaction in ______

A

liver

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6
Q

Esters are broken down by ______

A

plasma cholinesterase

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7
Q

Types of esters for infiltration

A

procaine (novacaine)
cholorprocaine (Nesacaine)
tetracaine (pontocaine)

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8
Q

Max plain dose of procaine (novacaine)

A

350-600 mg

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9
Q

max with epinephrine dose of chloroprocaine (nescaine)

A

1000 mg

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9
Q

Max with epinephrine dose of procaine (novacaine)

A

1000 mg

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9
Q

Max plain dose of chloroprocaine (nesacaine)

A

800 mg

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9
Q

other name for procaine

A

novacaine

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9
Q

other name for lidocaine

A

xylocaine

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9
Q

other name for tetracaine

A

pontocaine

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10
Q

other name for chloroprocaine

A

nesacaine

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10
Q

max plain dose of tetracaine

A

100 mg

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10
Q

types of amides

A

lidocaine (xylocaine)
mepivacaine (carbocaine)
bupivicaine (marcaine)

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11
Q

other name for mepivacaine

A

carbocaine

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12
Q

other name for bupivicaine

A

marcaine

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13
Q

Lidocaine 0.5-1% max plain dose

A

4.5 mg/kg or 300 mg

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14
Q

max with epinephrine dose of lidocaine

A

7 mg/kg or 500 mg

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15
Q

Mepivacaine 0.5-1% max plain dose

A

300 mg or 7mg/kg

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16
Q

max with epinephrine dose for Mepivacaine

A

500 mg

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17
Q

Bupivicaine 0.25% max plain dose

A

2.5mg/kg or 150 mg

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18
Q

max with epinephrine dose of Bupivicaine

A

225mg or 3mg/kg

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19
Q

four types of regional anesthesia

A

local infiltration
bier block IV
peripheral nerve blocks
central block

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20
Q

3 types of central nerve blocks

A

epidural
caudal
spinal

21
Q

Who can inject local infiltration?

A

surgeon
podiatrist
dentist

22
Q

indications for a bier block

A

brief procedure of hand or forearm
ex: carpal tunnel repair

23
Q

explain technique for bier block

A

20g IV in operative arm with extension tubing with 10 ml syringe, double pneumatic tourniquet on operative upper arm. elevate arm, then esmarch wrap distal to proximal. inflate distal cuff, then proximal. inflate to 250-300mHG, esmarch off, distal cuff deflated

24
Q

what dose of lidocaine 0.5% is administered during a bier block

A

3mg/kg - 40-50 ml injected slowly into IV

25
Q

complications of a bier block

A

accidental tourniquet release/leak

26
Q

injection of local into the epidural space

27
Q

two techniques of a epidural

A

hanging drop and loss of resistance technique

28
Q

what is the test dose of 1.5% lidocaine with epinephrine

A

1:200,000 mcg 3-5 ml Total

29
Q

names of epidural anesthetics

A

chloroprocaine (nescaine)
lidocaine
bupivicaine (marcaine)
ropivacaine

30
Q

plain dose of chloroprocaine 2-3%

A

200-750 mg

31
Q

dose of lidocaine 1-2% for epidural

A

150-300 mg

32
Q

dose of bupivicaine 0.25-0.5% for epidural

33
Q

dose of ropivacaine 0.25-1% for epidural

34
Q

caudals are typical in what patient population?

35
Q

injection of local into the subarachnoid space at lower lumbar area?

36
Q

names of drugs given during spinal:

A

tetracaine (pontacaine)
chloroprocaine
lidocaine
bupivicaine
ropivacaine

37
Q

plain dose of tetracaine for a spinal

38
Q

dose with epinephrine with tetracaine for a spinal

A

0.1-0.2 mg

39
Q

dose of chlorprocaine for a spinal

40
Q

epinephrine is not recommended for which drugs

A

chlorprocaine, lidocaine, bupivicaine, ropivacaine

41
Q

dose of lidocaine 5% for a spinal

42
Q

dose of bupivicaine 0.5-0.75% for a spinal

43
Q

dose of ropivacaine 0.5-1% for a spinal

44
Q

local mixed with sterile H20

45
Q

local mixed with spinal fluid/NSS

46
Q

local mixed with D10

A

hyperbaric

47
Q

indications for a spinal/epidural

A

lower extremity/hip procedure
lower abdomen, groin, perineum, urologic, rectal, ob procedure

48
Q

absolute contraindications for a spinal or epidural

A

refusal
infection at site
sepsis
severe hypovolemia
coagulation abnormaity
increase ICP

49
Q

relative contraindications for a spinal/epidural

A

infection peripheral to site
neurologic disorders
heparin/aspirin
back pain or prior lumbar surgery
hypovolemia
uncoperative patient or surgeon

50
Q

cardiovascular effects of a Spinal

A

decrease HR
decrease venous return
decrease BP

51
Q

respiratory effect of spinal

A

intercostal paralysis

52
Q

side effects of spinal block

A

sympathetic nervous system block
hypothermia
maintains peristalsis- contacted GI tract

53
Q

order of spinal blockade

A

sympathetic
temperature
pain
touch
pressure
motor
vibratory
proprioception

54
Q

how to treat hypotension from a spinal

A

prehydrate with fluids- 500-1000ml
ephedrine 5-10 mg/iv

55
Q

complications of a spinal

A

hypotension
post dural puncture headache
tinnitus
diplopia

56
Q

how to treat a post dural puncture headache from a spinal

A

analgesics
bedrest
hydration
caffeine infusion
blood patch

57
Q

ways to decrease incidence of the post dural Headache

A

smaller needle
turning bevel to side
paramedian
round/blunt tip
hydration

58
Q

complications of a epidural

A

hypotension
accidental spinal

59
Q

signs and symptoms of local drug toxicity

A

tinnitus
light headed
dizzy
slurred speech
confusion
circumoral numbness
metallic taste
low HR and BP
arrhythmias
seizures
death

Intro To Nurse Anesthesia (4 decks)

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