Principles of Procedural Sedation and Local and Regional Anesthesia Flashcards
Once inside the cell, they inhibit sodium channel function
T
Esters are metabolized by hydrolysis in the plasma by pseudocholinesterase. Amide anesthetics are metabolized in the liver
T
true allergic reaction to local anesthetic is common.
F true allergic reaction to local anesthetic is extremely rare
allergy to
esters are far more common than to amides
T
Factors that effect the Potency
by the degree oflipid
solubility of the drug
Duration of action is determined by the vasodilatory activities ofthe various drugs
T
Bupivacaine maximum dose
0.25-0.5 with epinephrine 225 without 175mg
It is hypothesized that the time
required for the body to alkalinize the solution to a physiologic pH
that will facilitate diffusion into the neuron prolongs the duration
to efficacious anesthesia
T
CNS toxicity occurs at a lower
dose range than CVS toxicity
T
CVS toxicity is more dangerous and more challenging to treat
T
Anesthesia CNS side effects
light-headedness, tinnitus, tremors, numbness ofthe lips or tongue, restlessness and CNS depression, seizures,
apnea, and loss of consciousness at high doses
The longer acting local anesthetics such as bupivacaine (Marcaine) may induce very difficult-to-treat
cardiac complications owing to the drugs’ special affinity for myocardial tissue and long half-life
T
epinephrine effect may be reversed with …….
phentolamine
in the tumescent technique,
doses of up to 35 mg/kg lidocaine are routinely safely administered
T
Peak serum lidocaine levels may occur as late as 10 to
14 hours after initial injection
T
only
approximately 50% ofinfiltrated local anesthetic is removed along with
the lipoaspirate
F only
approximately 20% ofinfiltrated local anesthetic is removed along with
the lipoaspirate
hyperventilation with 100% oxygen may alter the seizure
threshold and terminate the seizure
T
If seizure activity persists, diazepam (0.l mg/kg) or
thiopental (2 mg/kg) have also proven effective
T
Cocaine is the only local anesthetic that induces a vasoconstrictive,
rather than vasodilatory response
T
Cocaine is known to simultaneously augment cardiac output while also inducing coronary vasoconstriction, which may increase the risk ofmyocardial infarction
T
the ear cannot be completely blocked
, as terminal branches of cranial nerve ten and Arnold
nerve will require infiltrative anesthesia in the otic canal and conchal
bowl if intervention is required in the central ear
T
The superficial radial nerve emerges from the deep fascia of the
arm along the lateral aspect of the radius 6 to 9 cm proximal to the
radial styloid
T
Transversus Abdominis Plane Block can decrease the risk of DVT
T Deep vein thrombosis (DVT) risk is theoretically augmented in abdominal wall procedures by pain, which may inhibit postoperative mobility, and also augment pressure in the inferior vena cava,
which may lead to venous stasis in the legs and pelvis
The plane for injection of TAP block
in the plane between the internal oblique muscle and the transversus
muscle
The plane of pectoral nerve block
These may be approached in the plane between pectoralis major and minor just medial to the acromion
Midazolam is much shorter acting, lasting approximately
3 hours
T
Diazepam is longer acting, 6 to 12 hours.
T
Ketamine is a unique anesthetic because it does not depress the
respiratory drive
T
Ketamine
is relatively contraindicated in hypertensive patients
T
The chief advantage of
ketamine anesthesia is that patients may be anesthetized without the
need for endotracheal intubation.
T
Anesthetic onset is often marked by the initiation
of horizontal nystagmus
T
Nausea is a known side effect
of the ketamine
T
For cutaneous
anesthesia, the intercostal nerves may be accessed in the intercostal
spaces of ribs 2 to 5
T
Blocking the intercostal nerves lateral to the
anterior axillary line will effectively anesthetize both the lateral and
medial intercostal perforating cutaneous nerves
T
