Local Tech (EB) Flashcards
Technique for interpleural/interperitoneal local anesthesia
bupivacaine administered via chest drain or into abdominal cavity
How long does IP local anesthesia last?
4-6 hrs of effective analgesia
How can you prevent stinging with IP local anesthesia?
dilute w sodium bicarb
Technique for infiltration and incisional anesthesia
line block before surgical incision. Before or after incision close Multiple SC inj around area to be desensitized
With what procedures in intra-articular application most commonly used?
stifle surgery Arthroscopy
What LAs are used in intra-articular blocks?
bupivacaine post op Possible lidocaine
What LA should be used with an inflamed joint?
morphine than lidocaine be ph decreases
Types of facial/dental nerve blocks (4)
mental Mandibular (aka inferior alveolar) Intraorbital Maxillary
What nerve is blocked in a mental nerve block?
mental nerve - part of mandibular branch of trigeminus (CrN V)
What bones are affected by a mental nerve block?
bone, incisors, soft tissue rostral to 2nd mandibular premolar
What nerve is blocked by the mandibular nerve block?
inferior alveolar nerve block, branch of trigeminal nerve
What area is affected by a mandibular nerve block?
mandibular bone, teeth, soft tissue, tongue on infiltrated side
2 techniques for mandibular nerve block?
intraoral Extraoral
What nerve is blocked in the intraorbital nerve block?
part of the maxillary branch of trigeminus (v)
What areas are affected by an infraoribital nerve block?
bone, soft tissue, and dentition rostral to the maxillary first molar
If an infraorbital nerve block spreads caudally, what nerve block does it turn into?
maxillary block
What areas are desensitized in a maxillary nerve block?
maxillary bone Upper teeth Soft tissue Palate Nares Upper lip
Why are retrobulbar blocks not used often?
produces proptosis due to volume injected Distorts the globe Causes inc in IOP
When are retrobulbar blocks used?
eye enucleation
When is a digital nerve block performed?
onchectomy Digit amputation
What nerves are blocked in the digital nerve block?
superficial br of radial and medial n Dorsal and palmar br of ulnar n
What is an alternative to a digital nerve block?
ring block
Where is an epidural performed?
lumbosacral space (L7-S1)
How is the dog positioned in an epidural?
lateral or sternal
Do you have to be sterile when doing an epidural?
Duh, you’re going near the spinal cord
How slow should the epidural injection be?
over 1 minute
Orientation with the pelvis and L7 when doing an epidural
pelvic: wings of the ilia L7: proc. Transversus (?)
An epidural is performed _ dura mater
outside
What are the 2 names for spinal injections
intrathecal Subarachnoid
Where are spinal injections made?
in subarachnoid space L4-L5-L6 in dogs
How can drugs given in a spinal injection reach the brain?
mix with the CSF and flow cranially
Verification of correct needle placement with a spinal inj (3)
fluoroscopy (gold standard) “loss of resistance” Hanging drop
Drugs that can be used in epidural anesthesia (6)
lidocaine Bupivacaine Ropivacaine Morphine A2 adrenoceptor agonists Ketamine
What is the most important thing about the drug formulation with spinal blocks
preservative free
Onset and duration of morphine as an epidural? Bupivavaine?
Morphine, Onset: 30-90 min, Duration 16-24 hours. Bupivavaine: Onset: 3-4 min, Duration 4-6 hours
Indications for an epidural (5)
perineal surgery Tail amputation Hind limb surgery Thoracic surgery Lower abdominal surgery
What should be the ONLY anesthetic used in thoracic surgery?
morphine
Contraindications of an epidural (9)
skin infection at injection site Blood clotting problems Septicemia Fractured pelvis or spine (landmarks) Pre existing hypotension Meningitis CNS disorders Obesity? Discospondylitis?
Complications during an epidural procedure (9)
hypotension Epidural hemorrhage Spinal cord puncture/damage Cranial migration of drug Incomplete block Duration of hind limb paralysis Delayed hair growth Pruritis (from opioids) Urinary retention
What nerves are blocked in a brachial plexus block?
C6, C7, C8. T1
What area is blocked in a brachial plexus block?
distal to the elbow
What nerves are blocked in a brachial plexus block? (5)
radial Ulnar Musculocutaneous Median Axillary
Technique for a blind brachial plexus block (3 steps)
- Needle medial to tip of shoulder 2. advance toward costochondral junction 3. inject as needle withdrawn
What is the other technique of a brachial plexus block besides the blind one?
using a nerve locator
What drugs are used in a brachial plexus block?
lidocaine and/or bupivacaine
Risks/complications of brachial plexus blocks (5)
IV injection and toxicity Hematoma of the brachial artery Pneumothorax Nerve damage/paralysis»_space; lameness infection
