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RUSVM Anesthesiology 2016 > Locoregional Anesthesia > Flashcards

Locoregional Anesthesia Flashcards

1
Q

What are the types of Local Anesthesia?

A

Topical
SQ/Line block
Wound soaker

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2
Q

What are specific blocks for locoregional anesthesia?

A

Head
Thoracic limb
Pelvic limb
Thorax

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3
Q

What are some Topical Anesthesias?

A

EMLA cream
Lidoderm
Ophthalmic: Tetracaine or proparacaine
Laryngeal: Lidocaine for intubation in cats

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4
Q

What anesthetic is used for Intubation in cats?

A

Lidocaine

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5
Q

When is subcutaneous anesthesia used?

A

Utilized for wounds, masses, skin biopsy

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6
Q

When is a wound soaker catheter placed?

A

Total ear canal ablation
Oncologic surgery
Large wound closure

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7
Q

What are the complications of a wound soaker catheter?

A

Catheter dislodgement
disconnection
Local anesthetic toxicity
Delayed wound healing

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8
Q

What are the advantages of a wound soaker catheter?

A

technically simple
consistent and prolonged analgesia
decreased need for systemic analgesics

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9
Q

What are the peripheral nerve blocks?

A

Plexus
Intercostal
Paravertebral

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10
Q

What are the central/neuraxial nerve blocks?

A

Epidural

Spinal

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11
Q

“Bier Block”

A

Intravenous regional anesthesia (IVRA)

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12
Q

IVRA

A

Intravenous regional anesthesia

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13
Q

When is the Bier Block indicated?

A

Distal extremity

Procedure that is less than 60-90 mins

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14
Q

What are the advantages of the Bier Block?

A

Simple and reliable

Minimal blood loss/clear surgical field

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15
Q

What are the IVRA complications?

A 
Tourniquet pain 
Ischemia/nerve injury 
Limb swelling 
Hematoma
Local anesthesia toxicity
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16
Q

What are the peripheral nerve blocks of the head?

A 
Retrobulbar block 
Maxillary block 
Infraorbital block 
Inferior alveolar block 
Mental block
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17
Q

What are the indication for the retrobulbar block?

A

Enucleation
Evisceration/prothesis
Intraocular surgery

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18
Q

What are the nerve affected by the Retrobulbar block?

A 
CN II
CN III
CN IV
CN V
CN VI 
Ciliary ganglion (parasympathetic)
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19
Q

What are the advantages of the Retrobulbar block?

A

Post-op analgesia
Globe immobility during surgery
Decreased anesthetic and NMBD requirements

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20
Q

What are the complications of the Retrobulbar block?

A 
Retrobulbar hemorrhage 
Damage to optic nerve, extraocular mm. 
Globe penetration 
Intravascular injection 
Intrathecal injection (into optic nerve/ subarachnoid space)
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21
Q

What are the four dental blocks?

A

Infraorbital foramen
Middle Mental foramen
Vascular notch (mandible)
zygomatic arch

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22
Q

What nerve does the Maxilllary nerve block?

A

Sensory branch of CN V

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23
Q

What does the Maxillary nerve block provide anesthesia for?

A

Maxilla
teeth
soft tissues
Lateral aspect of nasal mucosa

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24
Q

What are the three techniques/approaches to the maxillary nerve block?

A

Subzygomatic
Maxillary tuberosity
Infraorbital

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25
Q

What does the

Infraorbital nerve block supply anesthesia to?

A

3rd premolar and teeth rostral
Rostral Maxilla
Soft tissues

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26
Q

What does the

Inferior alveolar nerve block supply anesthesia to?

A

Mandibular teeth
Rostral lower lip
Intermandibular space

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27
Q

What does the Mental nerve block supply anesthesia to?

A

Rostral lower lip

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28
Q

What are the Peripheral nerve blocks of the thoracic limb?

A

Cervical paravertebral block
Brachial plexus block
RUMM block
“declaw” block - Distal, radial, ulnar, median

29
Q

What does the cervical paravertebral nerve block supply anesthesia to?

A

Entire thoracic limb including scapular and shoulder joint

30
Q

What does the Brachial Plexus nerve block supply anesthesia to?

A

Distal to and including the elbow

31
Q

What nerves are blocked with the Brachial plexus nerve block?

A

C6 - suprascapular
C7 - Musculocutaneous
C8 - Radial
T1 - median and ulnar

32
Q

What does the

RUMM Block supply anesthesia to?

A

Distal thoracic limb

33
Q

What nerves are blocked by the RUMM block?

A

Radial
Ulnar
Median
Musculocutaneous

34
Q

What anesthetic is used in a declaw?

A

Bupivacaine

35
Q

What are the Peripheral nerve blocks for the pelvic limb?

A

Femoral nerve

Sciatic nerve

36
Q

What nerve block is used for Thoracotomys or rib fractures?

A

Intercostal nerve block

37
Q

What is the positioning for an epidural?

A

Sternal recumbency

38
Q

What is the concern for using a higher volume of drug in an epidural?

A

sympathetic blockade and hypotension

39
Q

What is the most common local anesthetic + opioid combo?

A

Bupivacaine + Morphine

40
Q

Where does Morphine L-S epidural provide analgesia?

A

Thoracic wall

Thoracic limbs

41
Q

What does the Auriculopalpebral nerve block cause?

A

Paralysis of orbicularis oculi mm.

42
Q

What is the common use for a Supraorbital nerve block in equine?

A

Placement of sub-palpebral lavage catheter

43
Q

What nerve block is used for standing enucleation in equine?

A

Retrobulbar block

44
Q

What blocks are used for equine dentals?

A

Infraorbital nerve block
Mental nerve block
Inferior alveolar nerve block

45
Q

What are the uses for a caudal epidural?

A

Control of rectal tenesmus
Correction of uterine torsion, fetotomy, obstetric manipulations
Tail amputation, rectovaginal fistula repairs, Caslick’s procedure
Hind limb procedures and pain

46
Q

Where do you place an epidural in an equine?

A

First coccygeal space (Co1-Co2)

47
Q

What drug is used for equine epidurals?

A

2% Lidocaine

48
Q

What are the alpha 2 agonists used with equine epidural?

A

Xylazine

Detomidine

49
Q

What is the common drug combinationfor equine epidural?

A

Detomidine + Morphine

50
Q

When is intra-articular morphine used?

A

analgesia post-arthroscopy

51
Q

What does the Peterson block block?

A

Oculomotor
trochlear
abducens
3 branches of trigeminal

52
Q

What do you block for dehorning in cattle?

A

Cornual branch of zygomaticotemporal nerve

53
Q

What do you block for dehorning in goats?

A

Cornual brainch of zygomaticotemporal nerve

cornual branch of infratrochlear nerve

54
Q

What are the two blocks for Regional Ruminant flank laparotomy?

A

Proximal paravertebral

Distal paravertebral

55
Q

What are the two blocks for Infiltration ruminant flank laparotomy?

A

Line Block

Inverted L block

56
Q

What region does the proximal paravertebral thoracolumbar anesthetize?

A

Dorsal and ventral branches of T13, L1, L2 spinall nerves

57
Q

What are the signs of the proximal paravertebral thoracolumbar blockade?

A

Absent reaction to pinprick
Increased skin temperature due to vasodilation
Spinal scoliosis towards desensitized side due to paralysis of paravertebral mm.

58
Q

What are the advantages of the proximal paravertebral thoracolumber block?

A

No disruption of incision site

Faster than line blocks

59
Q

What are the disadvantages of the proximal paravertebral thoracolumber block?

A

Technical difficulty
Scoliosis may cause difficulty closing incision
Risk of penetrating great vessels
Loss of motor control if LA migrates to femoral nerves

60
Q

What are the advantages of the distal paravertebral thoracolumber block?

A

Lack of scoliosis

Less risk of penetrating major blood vessels

61
Q

What are the disadvantages of the distal paravertebral thoracolumber block?

A

Larger amount of local anesthetic vessels

May be less effective

62
Q

What animals do you use the Lumbosacral epidural on?

A

Immature cattle
small ruminants
camelids
pigs

63
Q

Where do you place the Lumbosacral epidural?

A

L6-S1 space

64
Q

What drugs are commonly used with Lumbosacral epidurals?

A

Alpha 2 agonists

65
Q

What are the blocks used in teats?

A

Ring block
Inverted V block
Teat cistern infusion
IV regional anesthesia of the teat

66
Q

What blocks are used for the cranial aspect of udder and teats?

A

Paravertebral block of L1, L2, and L3

High caudal epidural

67
Q

What are the blocks used for the foot?

A

Ring block

IVRA

68
Q

What drug is used for testicular blocks for castration?

A

Lidocaine

RUSVM Anesthesiology 2016 (38 decks)

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