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Local Anesthesia > Patient Evaluation for Local Anesthesia > Flashcards

Patient Evaluation for Local Anesthesia Flashcards

1
Q

Angina is?

A

Chest pain

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2
Q

Stable Angina?

A

Character, duration, intensity, resolution, precipitating events all constant over time

caution with: Stress, Epinephrine

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3
Q

Unstable Angina?

A

Change in anything from stable

Angina at rest

Treat in monitored setting

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4
Q

Myocardial infarction is?

A

Destruction of an area of heart muscle as the result of occlusion of a coronary artery

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5
Q

Recent MI (caution with?)

A

Stress

Epinephrine

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6
Q

Prolonged MI (more than 6 months ago)

A

Variable

uncomplicated: relatively low risk
complicated: caution with stress, epinephrine

newer literature reduces this time to 6-8 weeks

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7
Q

Coronary artery bypass surgery (CABG)

A

Recent: caution with stress, epinephrine

More than 3 months ago: variable, similar to MI

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8
Q

Arrhythmia is?

A

any variation from the normal rhythm in the heartbeat

One of the most difficult areas to assess

Need PCP/Caridiologist consultation

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9
Q

Controlled arrhythmia

A

caution with Epinephrine

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10
Q

Refractory/uncontrolled arrhythmia

A

Treat in monitored setting

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11
Q

Hypertension (controlled)

A

consider drug interactions, monitor pressure
(ex. ACE inhibitor, and Beta blocker)

May need to reduce EPI use

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12
Q

Hypertension (Severe, untreated, uncontrollable)

A

limit EPI use

consider monitored setting

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13
Q

Congestive Heart Failure (CHF)

A

controlled: low risk

Uncontrolled, untreated: stress, time in chair are major issues

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14
Q

Stroke (Cerebrovascular disease)

A

low risk, watch BP

Vatiable risk for recurrence:
monitor pressure, may need to reduce EPI

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15
Q

Diabetes (controlled)

A

no problem

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16
Q

Diabetes (uncontrolled)

A

monitor for other problems

17
Q

Thyroid disease

A

controlled: no problem

18
Q

Uncontrolled Hyperthyroidism

A

Defer treatment

avoid stress, epinephrine (important because patient is very sensitive to epinephrine)

19
Q

Pheochromocytoma

A

Rare tumor

defer treatment

avoid EPI, stress

20
Q

Coagulopathy is?

A

bloods ability to coagulate (form clots) is impaired

21
Q

Coagulopathy

A

congenital or acquired

alter technique to avoid deep blocks (more chance to poke the blood vessels, so it will keep bleed, patient will have hematoma)

22
Q

Methemoglobinemia

A

Avoid PRILOCAINE

Lidocaine may be a trigger but is lowest risk anesthetic

23
Q

Methemoglobinemia is?

A

Dark brown blood: not a lot of oxygenated blood presents

24
Q

Asthma

A

no problem

25
Q

Chronic obstructive pulmonary disease (COPD)

A

Time in chair may be the issue

26
Q

Liver disease

A

Unlikely to be a significant issue

(at the end of liver disease: amide is metabolized at the liver, liver is not functional then local anesthesia would not be metabolized and stay in the system)

27
Q

Renal disease

A

Unlikely to be a significant issue

28
Q

Dialysis patients

A

treat day after dialysis

29
Q

Malignant Hyperthermia

A

No problem with AMIDE anesthetics

30
Q

Atypical plasma pseudocholinesterase

A

delayed metabolism of esters

amide anesthetics are NOT a problem

31
Q

Cocaine abuse (IMPORTANT)

A

avoid EPI, stress

defer treatment: 24 hours

32
Q

Preganacy

A

limit care generally (2nd trimester is OK)

Local anesthetics are ok

33
Q

Tricyclic antidepressants

A

Block neurotransmitter uptake

Monitor BP

34
Q

MAO inhibitors

A

limited clinical significance

Monitor BP

35
Q

Beta-blockers

A

selective: little concern

non-selective: monitor pressure with EPI use (can cause severe hypertension)

36
Q

LA with Amide

A

allergic rxn very rare but POSSIBLE

37
Q

LA with Esters

A

allergic rxn possible, but we aren’t injecting them anymore

38
Q

Parabens?

A

WE DO NOT USE

39
Q

Sulfites?

A

allergic rxn possible (in epi containing anesthetics)

Local Anesthesia (2 decks)

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