Principles of Procedural Sedation and Local and Regional Anesthesia

Question 1

Once inside the cell, they inhibit sodium channel function

Answer 1

T

Question 2

Esters are metabolized by hydrolysis in the plasma by pseudocholinesterase. Amide anesthetics are metabolized in the liver

Answer 2

T

Question 3

true allergic reaction to local anesthetic is common.

Answer 3

F true allergic reaction to local anesthetic is extremely rare

Question 4

allergy to
esters are far more common than to amides

Answer 4

T

Question 5

Factors that effect the Potency

Answer 5

by the degree oflipid
solubility of the drug

Question 6

Duration of action is determined by the vasodilatory activities ofthe various drugs

Answer 6

T

Question 7

Bupivacaine maximum dose

Answer 7

0.25-0.5 with epinephrine 225 without 175mg

Question 8

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

Answer 8

T

Question 9

CNS toxicity occurs at a lower
dose range than CVS toxicity

Answer 9

T

Question 10

CVS toxicity is more dangerous and more challenging to treat

Answer 10

T

Question 11

Anesthesia CNS side effects

Answer 11

light-headedness, tinnitus, tremors, numbness ofthe lips or tongue, restlessness and CNS depression, seizures,
apnea, and loss of consciousness at high doses

Question 12

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

Answer 12

T

Question 13

epinephrine effect may be reversed with …….

Answer 13

phentolamine

Question 14

in the tumescent technique,
doses of up to 35 mg/kg lidocaine are routinely safely administered

Answer 14

T

Question 15

Peak serum lidocaine levels may occur as late as 10 to
14 hours after initial injection

Answer 15

T

Question 16

only
approximately 50% ofinfiltrated local anesthetic is removed along with
the lipoaspirate

Answer 16

F only
approximately 20% ofinfiltrated local anesthetic is removed along with
the lipoaspirate

Question 17

hyperventilation with 100% oxygen may alter the seizure
threshold and terminate the seizure

Answer 17

T

Question 18

If seizure activity persists, diazepam (0.l mg/kg) or
thiopental (2 mg/kg) have also proven effective

Answer 18

T

Question 19

Cocaine is the only local anesthetic that induces a vasoconstrictive,
rather than vasodilatory response

Answer 19

T

Question 20

Cocaine is known to simultaneously augment cardiac output while also inducing coronary vasoconstriction, which may increase the risk ofmyocardial infarction

Answer 20

T

Question 21

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

Answer 21

T

Question 22

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

Answer 22

T

Question 23

Transversus Abdominis Plane Block can decrease the risk of DVT

Answer 23

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

Question 24

The plane for injection of TAP block

Answer 24

in the plane between the internal oblique muscle and the transversus
muscle

Question 25

The plane of pectoral nerve block

Answer 25

These may be approached in the plane between pectoralis major and minor just medial to the acromion

Question 26

Midazolam is much shorter acting, lasting approximately
3 hours

Answer 26

T

Question 27

Diazepam is longer acting, 6 to 12 hours.

Answer 27

T

Question 28

Ketamine is a unique anesthetic because it does not depress the
respiratory drive

Answer 28

T

Question 29

Ketamine
is relatively contraindicated in hypertensive patients

Answer 29

T

Question 30

The chief advantage of
ketamine anesthesia is that patients may be anesthetized without the
need for endotracheal intubation.

Answer 30

T

Question 31

Anesthetic onset is often marked by the initiation
of horizontal nystagmus

Answer 31

T

Question 32

Nausea is a known side effect
of the ketamine

Answer 32

T

Question 33

For cutaneous
anesthesia, the intercostal nerves may be accessed in the intercostal
spaces of ribs 2 to 5

Answer 33

T

Question 34

Blocking the intercostal nerves lateral to the
anterior axillary line will effectively anesthetize both the lateral and
medial intercostal perforating cutaneous nerves

Answer 34

T