Patient Monitoring and Local and Regional Anesthesia

Question 1

what are the four major types of anesthesia

Answer 1

general

regional

local

Monitored anesthesia care (MAC)

Question 2

measurement of co2 exhaled by patient

Answer 2

capnometry

Question 3

pertaining to above or or upon the dura, an injection into the space surrounding the dura matter

Answer 3

epidural

Question 4

pertaining to an injection through the dura matter into subarachnoid space and cerebrospinal fluid in lumbar area of spine

Answer 4

intrathecal

Question 5

parenteral administration of an anesthetic agent to nerve endings in the immediate surgical site

Answer 5

local anesthesia

Question 6

technique used to accomplish both sensory and motor block to an entire area of the body

Answer 6

regional anesthesia

Question 7

which agents are used to accomplish local and or regional anesthesia

Answer 7

lidocaine

bupivicaine

mepivacaine

Question 8

During BIS monitoring, interpret the meaning of a 50

Answer 8

The patient is deeply unconscious

Question 9

What is another name for a pulmonary artery catheterization?

Answer 9

Swan Genz

Question 10

By what route is cocaine used as a local anesthetic?

Answer 10

Topical

Question 11

A spinal anesthetic is most commonly done in the _____ area and is also known ________ injection.

Answer 11

Lumbar, intrathecal

Question 12

After a spinal or epidural anesthetic, patients may suffer from headaches due to:

Answer 12

CSF leakage

Question 13

additive to local anesthesia

Answer 13

sodium bicarbonate

Question 14

What does ASA stand for?

Answer 14

American Society of Anesthesiologists

Question 15

A slow pulse or dropping oxygen saturation during emergence from anesthesia may signal an emergency situation such as ______.

Answer 15

Laryngospasm

Question 16

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.

Answer 16

Muscle relaxants

Question 17

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.

Answer 17

Four stimuli

Question 18

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.

Answer 18

Arterial pressure

Question 19

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.

Answer 19

Central venous pressure

Question 20

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.

Answer 20

Tumescent

Question 21

Local anesthetic agents are chemically classified as either _____ or _______.

Answer 21

Aminoesters, aminoamides

Question 22

The most common local anesthetic agents used in surgery are aminoamides: _____(Xylocaine), _____ (Marcaine), and ______(Naropin).

Answer 22

Lidocaine, bupivacaine, ropivacaine

Question 23

Local anesthetics agents with epinephrine should NOT be used for peripheral infiltration anesthesia on ____, _____, external ____, external _____ or ____ because of vasoconstriction caused by epinephrine.

Answer 23

Fingers, toes, ear, nose, penis

Question 24

Alcohol will feel ____ on an unblocked area of skin and ____ or neutral on a blocked area.

Answer 24

Cold, warm

Question 25

An opioid such as ____ and _____ may be added to prolong duration of spinal anesthesia without prolonging recovery time.

Answer 25

Fentanyl, sufentanil

Question 26

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.

Answer 26

Blood patch

Question 27

_____ 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

Answer 27

Caudal

Question 28

_____ 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.

Answer 28

Retrobulbar

Question 29

Agents that may be administered during MAC include:

Answer 29

Midazolam (Versed)
Fentanyl (Sublimaze
Alfentanil (Alfenta)
Meperidine (Demerol)
Propofol (Diprivan)

Question 30

Which regional block is the only one that is intravenous?

Answer 30

Bier block (IVRA).

Question 31

What is an effect of lidocaine toxicity?

Answer 31

The CNS and cardiovascular system are affected. The patient may have hypertension, bradycardia, ventricular arrhythmias, and even cardiac arrest.

Question 32

assess cardiac function.

Answer 32

TEE transesophageal echocardiography

Question 33

mm Hg

Answer 33

millimeters of mercury

Question 34

What two ratios are epinephrine dosages expressed as?

Answer 34

1:100,000 / 1:200,000

Question 35

An axillary approach for arm block requires the injection of local anesthetic agents at which nerve network?

Answer 35

Brachial plexus

Question 36

To render an extremity bloodless by elevation or constriction is termed:

Answer 36

Exsanguination

Question 37

The generic name for Carbocaine is:

Answer 37

Mepivacaine

Question 38

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?

Answer 38

Axillary block