Peds Anesthesia Flashcards
Expected length in cm of a child based on age
(Age in years X 6) + 77
Sites of absorption for local anesthetics from greatest absorption to least
IV –> tracheal –> intercostal –> caudal epidural –> paracervical –> lumbar epidural –> brachial plexus –> sciatic –> subQ
Benefits of higher concentration local anesthetics
More dense motor block, longer duration
Conditions that potential LAST
Tissue acidosis, hypoxemia, hypercarbia
Parameters of positive test dose in regional anesthesia
Increase in T-wave 25% or more
Increase in BP by 15 mmHg or more
Increase in HR by 10 bpm or more
Typical emergency meds to avoid during LAST
Vasopressin
CCB
Lidocaine
Beta Blockers
Full dose epi
Dose of epinephrine to use in last
1mcg/mL (instead of 10)
Bolus dose for lipid emulsion of LAST
1.5mL/kg
Repeat if patient remains unstable
Infusion dose of lipid emulsion for LAST
0.25mL/kg/min
Double if patient remains unstable
Compartment perfusion pressure (such as in determining whether compartment syndrome exists)
Diastolic blood pressure - compartment pressure (normal comp. pressure 0 - 12 mmHg)
Hemodynamic factor most likely to change under TIVA with intravascular injection of local anesthetic
Blood pressure
Hydrophilic opioids
Morphine, hydromorphone
(Superior in epidural infusions)
Hydrophobic opioids
Fentanyl, alfentanil, sufentanil
Fibers more selectively affected by alpha2 agonists
C-fibers (pain) over A-alpha (motor)
Dose of ketamine for pain relief
0.25 - 1mg/kg
