Week 6 notes

Question 1

local analgesia does what?

Answer 1

blocks pain transmission

Question 2

When is local anesthesia utilized?

Answer 2

when patient is easy to handle, general anesthesia is undesirable or high risk, and means to deliver general anesthesia safely is unavailable.

Question 3

What are the advantages of local anesthesia?

Answer 3

Low cardiovascular toxicity, low cost, excellent pain control in the immediate postoperative period, and minimal patient recovery time.

Question 4

What determines local vs. general anesthesia?

Answer 4

DVM’s choice, temperament, age, species, physical status, cost, nature of procedure, and anesthetists skill.

Question 5

What are the local anesthetic agents we use?

Answer 5

Lidocaine, bupivacaine, mepivacaine, procaine, tetracaine, and proparacaine.

Question 6

what are the most commonly used local anesthetics?

Answer 6

Lidocaine and bupivacaine

Question 7

what %’s of Lidocaine do we use?

Answer 7

0.5 - 2

Question 8

What do we mix Lidocaine and bupivacaine with to dilute?

Answer 8

sterile saline

Question 9

Where does general anesthesia primarily effect the body?

Answer 9

primarily the neurons in the brain

Question 10

Where do local anesthetics exert their effect on the body?

Answer 10

exert effect on the neurons in the peripheral nervous system and spinal cord

Question 11

Local anesthetics are made useless by what?

Answer 11

fat, bone, cartilage, fascia, tendons, and inflammation and infection

Question 12

MoA of local anesthetics?

Answer 12

blockade of sodium channels, neurons can not generate electrical impulses, absorbed into local circulation and metabolized by the liver

Question 13

administration of local anesthetics may cause temporary?

Answer 13

paresis and paralysis

Question 14

what is ethyl chloride used for?

Answer 14

skin biopsies and superficial procedures

Question 15

what does eutectic mixture do? and what is it?

Answer 15

ELMA cream, mixture of 2.5% Lidocaine and 2.5% prilocaine. desensitizes intact skin for superficial minor procedures (catheterization)

Question 16

where is a splash block used and what caution should you take when using it?

Answer 16

utilized in wounds and/or open surgical sites. use caution to avoid overdose

Question 17

What are the maximum dosages for splash blocks for cats and dogs with Lidocaine and bupivacaine?

Answer 17

Lidocaine- cats ( 2mg/kg), dogs (4 mg/kg)

Bupivacaine- cats (0.5 mg/kg), dogs (2 mg/kg)

Question 18

what does infiltration route mean with local anesthetics?

Answer 18

injected into tissues in proximity to the target nerve

Question 19

What drug is most commonly used for filtration?

Answer 19

Lidocaine

Question 20

epinephrine + local anesthetic causes what?

Answer 20

constriction of blood vessels in the area of infiltration and prolongs the effect of Lidocaine by 50%

Question 21

Lidocaine + epinephrine should not be used when?

Answer 21

incision site, ears, digits, and tails

Question 22

epinephrine increases the risk of what?

Answer 22

ventricular arrhythmias

Question 23

what is the CRI dose of Lidocaine for dogs and horses? cats?

Answer 23

50-75 mcg/kg/min dog/horse, 25 mcg/kg/min cats

Question 24

What are some clinical situations to utilize nerve blocks?

Answer 24

lameness exam on a horse, dehorning cattle, dental blocks, chest surgery, amputation, and declawing

Question 25

What is a line block?

Answer 25

continuous line of local anesthetic placed in subcuticular tissues immediately proximal to the target area

Question 26

Line blocks are positioned where?

Answer 26

between the target area and the spinal cord

Question 27

What is a ring block?

Answer 27

line of local anesthetic completely encircles an anatomic part

Question 28

Line and ring blocks are used exclusively in what?

Answer 28

equine and food animal surgery

Question 29

What are some advantages of regional anesthesia?

Answer 29

wide, uniform area of anesthesia, shorter time required to perform block

Question 30

disadvantages of regional anesthesia?

Answer 30

technical skill required, hind limb weakness, and scoliosis

Question 31

Epidural anesthesia blocks sensation and motor control of the ?

Answer 31

rear, abdomen, pelvis, tail, pelvic limbs, and perineum

Question 32

Epidurals are most commonly used in what patients?

Answer 32

Ruminants, debilitated small animals, and patients requiring profound pain control post surgically

Question 33

What are the drugs of choice for epidurals?

Answer 33

2% Lidocaine, 0.5% bupivacaine, morphine, and combinations (opioids and alpha 2 agonists)

Question 34

What are some adverse effects of local anesthetics?

Answer 34

loss of voluntary motor control of affected body part, temporary or permanent loss of nerve function, tissue irritation, paresthesia, allergic reactions, systemic toxicity, spinal cord trauma, infiltration of the caudal spinal cord, and diffusion of anesthetic into the cervical and thoracic spinal cord

Question 35

Pain is?

Answer 35

unpleasant sensory or emotional experience associated with actual or potential tissue damage

Question 36

analgesia is?

Answer 36

the absence of the awareness of pain, achieved through the use of drugs or other modes of therapy

Question 37

Technicians must know what 5 principles of analgesia?

Answer 37

ensure analgesia is provided for every patient requiring it, recognize procedures likely to be painful, use techniques to minimize pain, monitor behavior and physiologic variables as potential indicators or pain, must bring animals requiring analgesia to the vet's attention

Question 38

Untreated pain can negatively affect a patient's ?

Answer 38

behavior, physiology, metabolism, and immune system

Question 39

What is your goal as a technician for animal pain?

Answer 39

provide adequate analgesia and sedation to allow your patients without undue discomfort to move, eat, sleep for 12 to 24 hours after surgery

Question 40

pain results when ?

Answer 40

nerve cells (nociceptors) in the skin or deep tissues detect noxious stimuli

Question 41

What are the types of pain and explain?

Answer 41

``` physiologic pain- ouch pain pathologic pain- broken bone neuropathic pain- nerve pain visceral pain- organ pain somatic pain- musculoskeletal pain idiopathic pain- no identifiable cause ```

Question 42

What are the chemicals released by inflammation or tissue damage?

Answer 42

prostaglandins, leukotrienes, bradykinin, proteolytic enzymes, histamine, potassium ions, serotonin

Question 43

what are the 3 pain stimuli's?

Answer 43

chemical stimuli, thermal stimuli, mechanical stimuli

Question 44

What are the two types of sensory neurons?

Answer 44

A delta fibers and c fibers

Question 45

A delta fibers transmit ?

Answer 45

sharp, discrete pain signals

Question 46

C fibers transmit ?

Answer 46

dull, aching or throbbing pain signals

Question 47

How do we classify pain?

Answer 47

mild, moderate or severe

Question 48

What are the behavioral responses to pain for dogs?

Answer 48

vocalization, facial expressions, body posture, guarding, self-mutilation, activity, attitude, appetite, urinary/bowel habits, grooming, response to palpation

Question 49

what are the behavioral responses to pain for cats?

Answer 49

vocalization, facial expression, body posture, guarding, self-mutilation, activity, attitude, appetite, urinary/bowel habits, grooming, and response to palpation

Question 50

What are some methods of pain control?

Answer 50

acupuncture, massage therapy, magnetic therapy, hot and cold therapy.

Question 51

what some things that go with conscientious nursing care?

Answer 51

comfortable bedding, quiet surroundings, gentle reassurance, monitoring