Locoregional Techniques for SA Flashcards
What is another name for the topical anesthetic that has lidocaine and prilocaine in it?
EMLA cream-requires occlusive dressing and 60 minutes before it takes affect
What medication can be used to dress along side an incision line?
Lidoderm-analgesic effect-not full block
Which drugs are used during IOP measurement?
Tetracaine/proparacaine
What topical anesthetic is commonly used in cats to reduce laryngeospasms?
Lidocaine (.1 mL 2%)-apply to arytenoids
What locoregional anesthetic technique would you use for total ear canal ablation, amputation, oncologic surgery and large wound closure surgeries?
Wound soaker catheter-allows consistent/prolonged analgesia
What is another name for intravenous regional anesthesia?
Bier block
When would you use a bier block?
Distal extremities for ~60 minute procedures
What type of anesthetic is injected during a bier block?
Lidocaine IV
How long can the tourniquet be placed for a bier block before potential nerve/tissue damage occurs?
60-90 minutes
What are the 5 peripheral nerve blocks of the head?
- Retrobulbar n. block
- Maxillary n. block
- Infraorbital n. block
- Inferior alveolar n. block
- Mental n. block
What type of nerve block is indicated for enucleation, evisceration and intraocular surgery?
Retrobulbar block
What nerves are affected during a retrobulbar block?
CN III. IV, V, VI and ciliary ganglion
What is the preferred technique of a retrobulbar n. block?
Inferior-temporal palpebral
What nerve does the maxillary nerve block act on?
The sensory branch of CN V
During a maxillary nerve block, where is the anesthesia acting on?
Ipsilateral maxilla, teeth, soft tissues and lateral nasal mucosa
What are the three techniques for the maxillary nerve block?
Subzygomatic, maxillary tuberosity and infraorbital
What nerve block provides anesthesia for the 3rd premolar and rostral teeth, rostral maxilla and soft tissues?
Infraorbital nerve block
Where is the infraorbital nerve block administered?
Dorsal to the distal root of 3rd premolar
Which route is preferred in cats for the infraorbital nerve block?
Extraoral
Which nerve block acts on a branch of the mandibular nerve?
Inferior alveolar n. block
What nerve may also be affected during the inferior alveolar block?
Lingual n. –> sensory to rostral 2/3 of tongue
T/F: the mental n. block provides anesthesia for the rostral lower lip only.
TRUE-no teeth are blocked
What are the four peripheral nerve blocks for the thoracic limb?
Cervical paravertebral block, brachial plexus block, RUMM block and “declaw” block
What nerve block provides anesthesia for the entire thoracic limb including scapula and shoulder joint?
Cervical paravertebral block-good for forelimb amputations-but difficult to do
Which nerve block provides anesthesia for thoracic limb distal to elbow?
Brachial plexus
How should the needle be advanced for the brachial plexus block?
Parallel to chest wall to avoid thoracic puncture
Where does the RUMM block provide anesthesia?
Distal thoracic limb including carpus (radial, ulnar, median and musculocutaneous nerves)
Where does peripheral nerve blocks for the pelvic limb provide anesthesia for?
Distal to mid-femur
Where does the intercostal nerve block provide anesthesia for?
Thoracotamy, rib fractures
Where do nerves run in relation to the ribs?
CAUDAL aspect- block at the site, 2 forward and 2 back as well (5 total areas)
Which nerve block is injected into thoracic cavity?
Intrapleural regional
How should the patient lay post intrapleural regional block?
Lay the patient affected side down-gravity will pull to affected area
Where are epidurals commonly performed?
L-S space in SA
What position should your patient be in for epidural?
Sternal recumbency with legs pulled forward (hanging drop technique)
How do you know that you are in the L-S space during an epidural procedure?
Loss of resistance- you initially go through supraspinous, interspinous ligaments and the ligamentum flavum–> once through it all you will feel a pop and release of pressre
What is the main concern with high volume injections in epidurals?
The anesthetic will spread more cranially causing concern for sympathetic blockade and hypotension
Which opioid administered L-S can provide analgesia to thoracic wall and thoracic limbs?
Morphine-not an anesthetic so we don’t worry about sympathetic block
Morphine is less lipid soluble- more cranial spread
What is a major complication of lumbosacral epidurals?
Hypotension
