Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Summer 2020 - Advanced Anesthesia - Pediatrics > Pediatric Pain Management - Final Wrap Up > Flashcards

Pediatric Pain Management - Final Wrap Up Flashcards

1
Q

What are the Advantages of using Regionals on Kids?

A

↓Gas & Opioid Use

↓Post-Op Apnea

↓Vascular Insufficiency

↓Clots

Supresses Neuroendocrine Response

↑GI Function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are Contraindications for Neuraxial Blocks on Kids?

A

Parent Refuse

Coagulopathy

Severe Infection

Neuro Problems

Hemodynamic Instability

On Chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the concerns r/t Neuraxial Blocks on Kids?

A

Neurotoxicity

Infection

Masking of Compartment Syndrome

Kid Needs to be Anesthetized/Held for Placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why must a test dose be used when placing a Neuraxial Block on kids?

A

Anesthetized kids CANNOT tell you symptoms of intravascular injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What precautions are needed when prepping a kid w/ Iodine or Chlorhexidine?

A

Iodine can be harmful to neonatal skin - must let dry & wash off when done

&

CHG good for indewlling catheters, but dont use if kid < 2 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What meds can prolong Post-Op pain relief to a Spinal?

A

Epi Wash

Morphine: 5-10 mcg/kg

Clonidine: 1-2 mcg/kig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which procedures are Spinals indicated?

A

Hernia Repair

Genital Procedures

Ex-Lap

Muscle Biopsy

Lower Extremity Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the Conus Medellaris & Dural Sac of an Infant vs. an Adult?

A

Infant:
Conus - L3
Dural Sac - S3

Adult:
Conus - L1
Dural Sac - S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much CSF is Neonates?

A

> 10 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much CSF is in Infants < 15kg?

A

4 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How much CSF is in children?

A

3 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How much CSF is in Adolescents & Adults?

A

1.5 - 2 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What position should the kid be in for placing a Neuraxial Block?

A

Sitting or Lateral w/ Neutral Neck to maintain airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where should the LA be injected for kids?

A

L4-L5 Space @ the Iliac Crest using a 1.5 in. needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the Pediatric Spinal Dosing of Tetracaine or Bupivacaine?

A

0.5 - 1 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the complications w/ Pediatric Spinals?

A

Difficult to Place

10-25% Failure

Short Duration w/o Morphine

Total Spinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In regards to Spinals, PDPH is very _____ in kids younger than 8

A

In regards to Spinals, PDPH is very RARE in kids younger than 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common regional used in kids?

A

Caudal Blocks - good for lower thoracic to lower extremities

19
Q

What are the Contraindications for Caudals?

A

Pilonidal Cyst

Abnormal Superficial Landmarks

Neuro Problems

Parent Refuse

20
Q

What forms the Sacral Hiatus?

A

Lack of fusion of S4 & S5 Arches

21
Q

What is the Sacral Hiatus?

A

V-shaped Aperture covered by sacrococcygeal membrane

22
Q

What type of needles are used for Pediatric Caudals?

A

Blunt Caudal Needle

Tuohy

22g Angiocath

23
Q

What is the positioning for Caudal Placement?

A

Lateral in Fetal Position

or

Prone

24
Q

What is the goal of Single Shot Caudals?

A

To provide intraoperative & prolonged post-operative analgesia

25
Q

The caudal epidural space in children need a _____ volume to fill the packed space & spread to the appropriate dermatomes

A

The caudal epidural space in children need a HIGH volume to fill the packed space & spread to the appropriate dermatomes

26
Q

How much LA is needed for the Pediatric Sacral Level?

A

0.5 - 0.75 mL/kg

27
Q

How much LA is needed for the Pediatric Lumbar Level?

A

1 - 1.2 mL/kg

28
Q

How much LA is needed for the Pediatric Low Thoracic Level?

A

1.2 - 1.5 mL/kg

29
Q

What is the Max Volume & Dose of LA for kids?

A

Max Volume: 25 mL

Max Dose: 3 mg/kg

30
Q

What is the treatment for LA Toxicity in Kids?

A

20% Intralipid

Bolus 1.5 mL/kg x 3 if needed

Then Infuse @ 0.25 mL/kg/min x 30-60 min

31
Q

True or False: When placing a Caudal, the absence of blood is a reliable indicator of not being in a blood vessel.

A

FALSE

32
Q

What is the Caudal Test dose of Epinephrine w/ Sevoflurane?

A

0.1 mL/kg of LA + 5 mcg/mL of Epi

Max: 3 mL

33
Q

When using a Test dose for Caudals, what indicates changes indicate Intravascular Injection?

A

↑HR by 10 bpm

↑BP by 15 mmHg

↑T-Wave by 25%

Bradycardia

34
Q

Why are kids more at risk for LA Toxicity?

A

They have ↑CO & ↑Systemic Uptake

35
Q

What are signs of LA Neurotoxicity?

A

HA

Somnolence

Vertigo

Paresthesias

Tremors/Twitching

Shivering

Convulsions

36
Q

What are signs of LA CV Toxicity?

A

Dysrhythmias

Wide QRS

Torsades

V-Tach

CV Collapse

37
Q

What should be avoided to prevent LA Toxicity?

A

Hypothermia

Hypercarbia

Acidosis

Hyperkalemia

Fast Injection

38
Q

How should the Max Infusion Rate of LA be adjusted for Neonates & Infants younger than 3-5 months?

A

Reduce by 50% of recommended dose for Older Infants & Children

39
Q

Besides Opioids, what meds can be used for Pediatric Pain Control?

A

Oral/Rectal Tylenol

&

Toradol

40
Q

What is the concern when giving Codeine to kids w/ abnormal levels of CYP2D6?

A

Too Little CYP2D6 = No Analgesia

Too Much CYP2D6 = Respiratory Depression & Death

41
Q

What is the result of using a PCA for kids 7 and older for Post-Op Pain, Vaso-Occlusive Crises, & Cancer Pain?

A

Safe & Effective

42
Q

What can Topical Eutectic Mixture of Lidocaine + Prilocaine be used for?

A

Reduces pain for Venepunctures

More = More Pain Relief

43
Q

What is a S-Caine (Synera) Patch?

A

Lidocaine + Tetracaine + Oyxgen-Activated Heat used for Venous Cannulation pain

44
Q

What is the main indication for an Ilio-Inguinal Iliohypograstric Block?

A

Hernia Repairs

Summer 2020 - Advanced Anesthesia - Pediatrics (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions