Regional anesthetic

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Regional anesthetic
2010-10-16 14:09:50
regional anesthetics local topical

questions for regional anesthetic knowledge
Show Answers:

  1. List 2 purposes of regional anesthesia
    • - block pain perception
    • - sometimes block motor activityat a targeted anatomical area
  2. List the 3 membranes around the spinal cord
    • pia mater
    • arachnoid
    • dura
  3. Which space contains Nerve roots and CSF?
    a) epidural space
    b) subarachnoid space?
  4. Which space contains nerves, fat, lymphatic vessels and veins?
    a) epidural space
    b) subarachnoid space?
  5. List 3 types of nerve fibres in spinal nerves
    • sensory
    • motor
    • autonomic
  6. The following sites are common for what type of regional anesthesia?
    eye; tympanic membrane, upper airways
  7. List a complication to watch for with topical anesthesia to the eye
    - if blink reflex is absent, eye patch may be necessary to prevent corneal abrasions
  8. List a complication to watch for with topical anesthesia to the throat
    • - loss of protective reflexes eg gag, cough
    • - watch for signs of ineffective airway clearance
  9. Topical anesthesia to which area increases the risk of systemic uptake and toxicity due to being highly vascular?
  10. What type of block injects local anesthetic into the subcutaneous tissue?
    local infiltration
  11. Which nerve fibres are blocked in local infiltration?
  12. Which nerve fibre(s) is affected in conduction or nerve blocks
    sensory and motor
  13. List common areas for conduction/nerve blocks
    • retrobulbar
    • ankle block
    • brachial plexus (interscalene block)
    • intercostal
    • ilioinguinal or iliohypogastric
    • penile
  14. List 2 complications of retrobulbar block
    • retrobulbar hemorrhage
    • bradycardia caused by activation of the oculocardiac reflex
    • toxicity
    • perforation of globe
    • accidental anesthesia of the brainstem - resp arrest/unconsciousness
  15. The following are complications of what type of block?
    - accidental vertebral artery injection
    - seizures
    - cardiac arrest
    - phrenic nerve block leading to resp failure
    - recurrent laryngeal nerve block - hoarseness
    - pneumothorax
    brachial plexus interscalene block
  16. The following are complications of what type of block?
    - vascular injection
    - pneumothorax
    intercostal nerve block
  17. The following are complications of what type of block
    - femoral nerve block
    - hematoma
    ilioinguinal nerve block
  18. What is the maximum inflation time for the tourniquet in a bier block?
    1.5 hrs
  19. At what point in a bier block does the greatest risk of local anesthetic toxicity occur?
    during deflation of tourniquet. Done slowly and intermittently
  20. The following are important to assess in what type of block?
    - S & S of systemic anesthetic toxicity
    - CSM in affected limb
    -bier block
  21. List 5 signs of central nervous system local anesthetic toxicity
    • metallic taste
    • numbness in tongue
    • ringing in ears
    • slurred speech
    • confusion
    • nausea
    • excitation
    • muscle twitching
    • seizures
    • lightheadedness
    • decreased LOC
  22. List 5 signs of respiratory and cardiovascular system local anesthetic toxicity
    • difficulty breathing
    • apnea
    • resp depression or arrest
    • decreased CO
    • hypotension
    • arrthymias
    • increased pr and qrs complex duration
  23. List 5 MILD signs of local anesthetic toxicity
    • anxiety
    • restlessness
    • numb tongue
    • tinnitus
    • lightheadedness
    • drowsiness
    • disorientation
    • increased PR/QRS intervals
    • hypotention
    • decreased CO
  24. List 5 SEVERE signs of local anesthetic toxicity
    • muscle twitching
    • tremors of face and extremities
    • seizures
    • unconsciousness
    • resp arrest
    • marked hypotension and decreased CO
    • dramatic increases in PR/QRS
    • arrhythmias like AV block, bradycardia asystole
  25. List treatment for MILD local anesthetic toxicity
    • document and report symptoms
    • monitor
    • may not need treatment
  26. List treatment for SEVERE local anesthetic toxicity
    • airway management
    • hypotension - IV fluids, vasopressors
    • arrhythmias - meds/ cardioversion
    • seizures - meds