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Regional Blocks > Regional Blocks > Flashcards

Regional Blocks Flashcards

1
Q

Lidocaine

A

-Duration 1-2 hours (2-6 w/ epi)
-CNS toxicity, seizures
-rapid onset

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2
Q

Bupivacaine

A

-Duration 2-4 hours (3-7 w/ epi)
-slow onset
-CV toxicity (heart blocks, hypotension, dysrhythmias)

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3
Q

Ropivacaine

A

-Rapid onset
-Duration 4-6 hours
-Less motor block

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4
Q

T4 Dermatone

A

Nipple

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5
Q

T6 dermatone

A

Xiphoid process

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6
Q

T10 dermatone

A

Umbilicus

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7
Q

L4 dermatone

A

Knees

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8
Q

S2-5 dermatones

A

Genitalia -buttocks

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9
Q

Motor Assessment

A

0/5 No movement
1/5 flick
2/5 unable to overcome gravity
3/5 overcome gravity, no resistance
4/5 some resistance
5/5 normal strength

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10
Q

Cervical plexus block

A

-C2-4
-anterolateral neck & ear, and skin inferior to clavicle on chest wall
-procedures: carotid endartectomy, thyroidectomy, proximal clavicle fractures

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11
Q

Interscalene nerve block

A

-C5-7
-part of clavicle, scapula, whole shoulder. Numbness extends to digits 1-3
-weakness of deltoid muscle and some hand muscles
-surgeries: shoulder, ORIF of clavicle/scapula, mid numeral shaft fracture
-Complications: diaphragmatic paralysis on blocked side from phrenic nerve block (25% dec in plum function); pneumothorax; Horner Syndrome; Bezold-Jalisco reflex (hypotension & Bradycardia); LAST
-Use Arm Sling

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12
Q

Horner Syndrome

A

-hoarse voice, constricted pupil (myosin), drooping eyelid (ptosis), nasal congestion, dec sweating (anhidrosis)
-Risk for blocks: Interscalene, supraclavicular
-self-limiting… reassure pt

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13
Q

Supraclavicular Block

A

-Affects arm below mid-humerus
-Motor and sensory loss entire arm below elbow
-surgeries: mid shaft humerus, biceps tendon repair, ORIF elbow, surgery of hand/foreman/digits
-**complications: phrenic nerve paralysis, Horner syndrome, hemothorax, pneumothorax
-*Use Sling

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14
Q

PECs block

A

-LA injected into the fasical plane between PECs major and minor muscles; C5-T1
-SENSORY block
-surgeries: after breast surgery, after thoracotomy, rib fx, axilla
-possible need for sling

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15
Q

Serratus Plane Block

A

-LA injecjected in the fasical plane of serratus anterior muscles to block upper intercostal nerves T3-T9
-SENSORY
-surgeries: after breast, after thoracotomy, rib fix, axiilla
-possible need for sling

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16
Q

Paravertebral Block

A

-LA injected alonside thoracic or lumbar vertebrae T1-T6
-*complications: High epidural/block block can occur, pneumothorax, LAST
-surgeries: breast, thoracotomy, non-invasive heart, rib fx, abd procedures

17
Q

Erector Spinae Plane Block

A

-LA injected deep into vertical back muscles. Spreads vertically and wraps around front of chest and upper abd
-SENSORY T3-T9
-Place block in upright position
-surgeries: rib fx, thoracic surgery (VATS), breast, bariatric, cardiac

18
Q

Quadratus Lumborum Block

A

-fascial plane block of the posterior wall of the abd and affects the back muscles
-SENSORY block to abd and hip regions T4-L1
-surgeries: upper/lower abd surgeries; some hip; cesarean, hysterectomy, renal transplant, nephrectomy, iliac crest bone graft

19
Q

Fascia Iliaca Block

A

-LA injected under the inguinal ligament and above the iliopsoas muscle; fasical plane
-affects the upper leg and inside of lower leg
-*FALL RISK: limb/leg brace: weakness of Quads. Numbness felt in anterior thigh, medial leg and big toe
-surgeries: total posterior/lateral hip replacements; hip/femoral fx; knee; AKA/BKA

20
Q

Femoral Block

A

-MOTOR and SENSORY loss to anterior thigh, anterior knee. ONLY SENSORY to medial calf/ankle
-posterior thigh and knee will have full sensation
-pt positioned supine
-*FALL RISK: motor block to quads
-surgeries: total knee replacement, ACL, knee arthroscopy, ORIF patella

21
Q

Anterior Sciatic Block

A

MOTOR & SENSORY to posterior knee, hamstring, and entire lateral lower leg (not medial)
*FALL RISK, foot drop

22
Q

IPACK block

A

SENSORY block to posterior knee

23
Q

Popliteal/Sciatic Block

A

MOTOR & SENSORY block to lateral leg below and behind knee (medial not blocked)
-FALL RISK
-contraindicated with neuropathies and DM

24
Q

Adductor Canal Block

A

-SENSORY to anterior and medial lower leg

25
Q

Lipid bolus tx for LAST

A

1.5 ml/kg bolus then 0.25-0.5 ml/g/min gtt

26
Q

Regional Anesthesia loss and return of sensation/movement

A

Loss:
-autonomic (bladder, Vado motor)
-temp
-pain
-touch
-movement
-proprioception

RECOVERY BACKWARDS

Regional Blocks (2 decks)

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