Regional Anesthetics

Question 1

What are three common types of regional anesthesia?

Answer 1

1. local infiltration
2. peripheral nerve block
3. spinal block

Question 2

Name four examples of regional anesthetics:

Answer 2

1. lidocaine
2. ropivicaine
3. bupivicaine
4. mepivicaine

Question 3

Why is epinephrine sometimes added to a regional anesthetic?

Answer 3

To extend the duration of the block (it causes vasoconstriction at the site of the block)

Question 4

Why is dextrose sometimes added to regional anesthetic?

Answer 4

It may be added to spinal blocks to extend duration (makes CSF heavier)

Question 5

Why is sodium bicarbonate sometimes added to regional anesthetic?

Answer 5

It reduces pain on infiltration and extends duration of the block

Question 6

What does L.A.S.T. stand for?

Answer 6

Local anesthesia systemic toxicity

Question 7

How does L.A.S.T. occur?

Answer 7

LAST can occur if an excessive dose of local anesthesia is absorbed systemically or if it is accidentally injected into the vascular space

Question 8

What are CNS symptoms associated with LAST?

Answer 8

1. dizziness
2. confusion
3. tingling/numb lips
4. blurred vision
5. metallic taste
6. seizures
7. hallucinations
8. loss of consciousness
9. respiratory arrest

Question 9

What are cardiac symptoms associated with LAST?

Answer 9

1.tachycardia
2. bradycardia
3. ventricular dysrhythmias
4. hypertension
5. cardiac arrest

Question 10

How is LAST treated?

Answer 10

anti-arrhythmics, fluids, oxygen, airway support, lipid emulsion therapy, benzodiazepines for seizures

Question 11

How does lipid emulsion therapy work?

Answer 11

lipids pull the local anesthesia out of the cardiac tissue