Local Tech (EB)

Question 1

Technique for interpleural/interperitoneal local anesthesia

Answer 1

bupivacaine administered via chest drain or into abdominal cavity

Question 2

How long does IP local anesthesia last?

Answer 2

4-6 hrs of effective analgesia

Question 3

How can you prevent stinging with IP local anesthesia?

Answer 3

dilute w sodium bicarb

Question 4

Technique for infiltration and incisional anesthesia

Answer 4

line block before surgical incision. Before or after incision close Multiple SC inj around area to be desensitized

Question 5

With what procedures in intra-articular application most commonly used?

Answer 5

stifle surgery Arthroscopy

Question 6

What LAs are used in intra-articular blocks?

Answer 6

bupivacaine post op Possible lidocaine

Question 7

What LA should be used with an inflamed joint?

Answer 7

morphine than lidocaine be ph decreases

Question 8

Types of facial/dental nerve blocks (4)

Answer 8

mental Mandibular (aka inferior alveolar) Intraorbital Maxillary

Question 9

What nerve is blocked in a mental nerve block?

Answer 9

mental nerve - part of mandibular branch of trigeminus (CrN V)

Question 10

What bones are affected by a mental nerve block?

Answer 10

bone, incisors, soft tissue rostral to 2nd mandibular premolar

Question 11

What nerve is blocked by the mandibular nerve block?

Answer 11

inferior alveolar nerve block, branch of trigeminal nerve

Question 12

What area is affected by a mandibular nerve block?

Answer 12

mandibular bone, teeth, soft tissue, tongue on infiltrated side

Question 13

2 techniques for mandibular nerve block?

Answer 13

intraoral Extraoral

Question 14

What nerve is blocked in the intraorbital nerve block?

Answer 14

part of the maxillary branch of trigeminus (v)

Question 15

What areas are affected by an infraoribital nerve block?

Answer 15

bone, soft tissue, and dentition rostral to the maxillary first molar

Question 16

If an infraorbital nerve block spreads caudally, what nerve block does it turn into?

Answer 16

maxillary block

Question 17

What areas are desensitized in a maxillary nerve block?

Answer 17

maxillary bone Upper teeth Soft tissue Palate Nares Upper lip

Question 18

Why are retrobulbar blocks not used often?

Answer 18

produces proptosis due to volume injected Distorts the globe Causes inc in IOP

Question 19

When are retrobulbar blocks used?

Answer 19

eye enucleation

Question 20

When is a digital nerve block performed?

Answer 20

onchectomy Digit amputation

Question 21

What nerves are blocked in the digital nerve block?

Answer 21

superficial br of radial and medial n Dorsal and palmar br of ulnar n

Question 22

What is an alternative to a digital nerve block?

Answer 22

ring block

Question 23

Where is an epidural performed?

Answer 23

lumbosacral space (L7-S1)

Question 24

How is the dog positioned in an epidural?

Answer 24

lateral or sternal

Question 25

Do you have to be sterile when doing an epidural?

Answer 25

Duh, you're going near the spinal cord

Question 26

How slow should the epidural injection be?

Answer 26

over 1 minute

Question 27

Orientation with the pelvis and L7 when doing an epidural

Answer 27

pelvic: wings of the ilia L7: proc. Transversus (?)

Question 28

An epidural is performed _ dura mater

Answer 28

outside

Question 29

What are the 2 names for spinal injections

Answer 29

intrathecal Subarachnoid

Question 30

Where are spinal injections made?

Answer 30

in subarachnoid space L4-L5-L6 in dogs

Question 31

How can drugs given in a spinal injection reach the brain?

Answer 31

mix with the CSF and flow cranially

Question 32

Verification of correct needle placement with a spinal inj (3)

Answer 32

fluoroscopy (gold standard) "loss of resistance" Hanging drop

Question 33

Drugs that can be used in epidural anesthesia (6)

Answer 33

lidocaine Bupivacaine Ropivacaine Morphine A2 adrenoceptor agonists Ketamine

Question 34

What is the most important thing about the drug formulation with spinal blocks

Answer 34

preservative free

Question 35

Onset and duration of morphine as an epidural? Bupivavaine?

Answer 35

Morphine, Onset: 30-90 min, Duration 16-24 hours. Bupivavaine: Onset: 3-4 min, Duration 4-6 hours

Question 36

Indications for an epidural (5)

Answer 36

perineal surgery Tail amputation Hind limb surgery Thoracic surgery Lower abdominal surgery

Question 37

What should be the ONLY anesthetic used in thoracic surgery?

Answer 37

morphine

Question 38

Contraindications of an epidural (9)

Answer 38

skin infection at injection site Blood clotting problems Septicemia Fractured pelvis or spine (landmarks) Pre existing hypotension Meningitis CNS disorders Obesity? Discospondylitis?

Question 39

Complications during an epidural procedure (9)

Answer 39

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

Question 40

What nerves are blocked in a brachial plexus block?

Answer 40

C6, C7, C8. T1

Question 41

What area is blocked in a brachial plexus block?

Answer 41

distal to the elbow

Question 42

What nerves are blocked in a brachial plexus block? (5)

Answer 42

radial Ulnar Musculocutaneous Median Axillary

Question 43

Technique for a *blind* brachial plexus block (3 steps)

Answer 43

1. Needle medial to tip of shoulder 2. advance toward costochondral junction 3. inject as needle withdrawn

Question 44

What is the other technique of a brachial plexus block besides the blind one?

Answer 44

using a nerve locator

Question 45

What drugs are used in a brachial plexus block?

Answer 45

lidocaine and/or bupivacaine

Question 46

Risks/complications of brachial plexus blocks (5)

Answer 46

IV injection and toxicity Hematoma of the brachial artery Pneumothorax Nerve damage/paralysis >> lameness infection