Patient Monitoring and Local and Regional Anesthesia Flashcards
what are the four major types of anesthesia
general
regional
local
Monitored anesthesia care (MAC)
measurement of co2 exhaled by patient
capnometry
pertaining to above or or upon the dura, an injection into the space surrounding the dura matter
epidural
pertaining to an injection through the dura matter into subarachnoid space and cerebrospinal fluid in lumbar area of spine
intrathecal
parenteral administration of an anesthetic agent to nerve endings in the immediate surgical site
local anesthesia
technique used to accomplish both sensory and motor block to an entire area of the body
regional anesthesia
which agents are used to accomplish local and or regional anesthesia
lidocaine
bupivicaine
mepivacaine
During BIS monitoring, interpret the meaning of a 50
The patient is deeply unconscious
What is another name for a pulmonary artery catheterization?
Swan Genz
By what route is cocaine used as a local anesthetic?
Topical
A spinal anesthetic is most commonly done in the _____ area and is also known ________ injection.
Lumbar, intrathecal
After a spinal or epidural anesthetic, patients may suffer from headaches due to:
CSF leakage
additive to local anesthesia
sodium bicarbonate
What does ASA stand for?
American Society of Anesthesiologists
A slow pulse or dropping oxygen saturation during emergence from anesthesia may signal an emergency situation such as ______.
Laryngospasm
During general anesthesia, ____ ____ are administered to facilitate endotracheal intubation and a relaxed surgical site. A nerve stimulator is used to asses neuromuscular function and the extent of blockade.
Muscle relaxants
A stimulus (form a nerve stimulator) is delivered to the nerve from a surface electrode or probe, often placed at the ulnar nerve or a branch of the facial nerve. ____ ____ (called a “train of four,” or TOF) are administered, and the extent of the block is estimated based on the twitch response.
Four stimuli
Invasive monitoring: _____ ____ monitoring catheter (also known as arterial line or “art-line”) is usually placed in the radial artery and connected to a transducer that records continuous, immediate and highly accurate measurement of blood pressure.
Arterial pressure
Invasive monitoring: When indicated, a ____ ___ ____ monitoring catheter (CVP line) is positioned in the superior vena cava and is used to assess the volume of blood returning to the heart. A CVP line is also used to assess the need for fluid replacement and to prevent fluid overload.
Central venous pressure
A specialized type of local infiltration is called _____ anesthesia and it is widely used in aesthetic surgery such as liposuction. The solution commonly contains 0.05% to 0.1% lidocaine, epinephrine and normal saline.
Tumescent
Local anesthetic agents are chemically classified as either _____ or _______.
Aminoesters, aminoamides
The most common local anesthetic agents used in surgery are aminoamides: _____(Xylocaine), _____ (Marcaine), and ______(Naropin).
Lidocaine, bupivacaine, ropivacaine
Local anesthetics agents with epinephrine should NOT be used for peripheral infiltration anesthesia on ____, _____, external ____, external _____ or ____ because of vasoconstriction caused by epinephrine.
Fingers, toes, ear, nose, penis
Alcohol will feel ____ on an unblocked area of skin and ____ or neutral on a blocked area.
Cold, warm
An opioid such as ____ and _____ may be added to prolong duration of spinal anesthesia without prolonging recovery time.
Fentanyl, sufentanil
Severe postdural puncture headaches may be treated by administration of a “_____ ____, “ that is, an injection of 10 to 15mL of the patient’s blood at the original spinal injection site.
Blood patch
_____ anesthesia is a type of epidural block injected into the epidural space via the sacral canal. It is used for vaginal childbirth and administered in the obstetrical unit rather than the OR. It may be used in conjunction with general anesthetics for urologic and lower-extremity surgical procedures in children and for postoperative pain management
Caudal
_____ blocks are injected behind the eye into the muscle cone to block branches of the oculomotar nerve. These blocks may be used for procedures requiring a motionless, anesthetized eye. A typical injection is made up of equal parts of 0.5% to 0.75% bupivacaine and 2% lidocaine with 150 units of hyaluronidase.
Retrobulbar
Agents that may be administered during MAC include:
Midazolam (Versed)
Fentanyl (Sublimaze
Alfentanil (Alfenta)
Meperidine (Demerol)
Propofol (Diprivan)
Which regional block is the only one that is intravenous?
Bier block (IVRA).
What is an effect of lidocaine toxicity?
The CNS and cardiovascular system are affected. The patient may have hypertension, bradycardia, ventricular arrhythmias, and even cardiac arrest.
assess cardiac function.
TEE transesophageal echocardiography
mm Hg
millimeters of mercury
What two ratios are epinephrine dosages expressed as?
1:100,000 / 1:200,000
An axillary approach for arm block requires the injection of local anesthetic agents at which nerve network?
Brachial plexus
To render an extremity bloodless by elevation or constriction is termed:
Exsanguination
The generic name for Carbocaine is:
Mepivacaine
Which method of anesthesia is likely to be used for a 45-year old, alcohol-intoxicated man for a closed reduction and cast application of a fractured forearm?
Axillary block
