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Anesthesiology > Locoregional Nerve Blocks- Small Animal > Flashcards

Locoregional Nerve Blocks- Small Animal Flashcards

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1
Q

What are the four methods of local anesthesia?

A
  1. Topical
  2. SubQ
  3. Line blocks
  4. Wound soaker catheter
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2
Q

What are two types of topical anesthesia administration?

A
  1. EMLA cream- lidocaine + prilocaine)

2. Lidoderm- 5% lidocaine patches

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3
Q

Do lidoderm patches provide a complete block?

A

No- only analgesic effects

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4
Q

What drugs are used for opthalmic analgesia?

A

Tetracaine or proparacaine

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5
Q

What drug is used for laryngeal anesthesia?

A

2% lidocaine- usually for intubation

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6
Q

What is SQ local anesthesia used for?

A

Wounds, masses, or biopsy

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7
Q

T/F: Ventral midline blocks have conflicting evidence for actually decreasing pain.

A

True

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8
Q

What is a wound soaker catheter?

A

A long fenestrated closed tip catheter that is placed during surgery deeply close to visualized nerves

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9
Q

What are wound soaker catheters used for?

A
  1. Total ear canal ablation
  2. Amputation
  3. Oncology surgery
  4. Large wound closure
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10
Q

What are complications associated with wound soaker catheters?

A
  1. Catheter dislodgement or disconnection
  2. Local anesthetic toxicity
  3. Delayed wound healing
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11
Q

What are some advantages to wound soaker catheters?

A
  1. Technically simple
  2. Consistent and prolonged analgesia
  3. Decreased need for systemic analgesics
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12
Q

What are the indications for a bier block?

A

Distal extremity procedures

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13
Q

What are some advantages of a bier block?

A
  1. Simple and reliable

2. Minimal blood loss and clear field

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14
Q

What is the procedure for a bier block?

A
  1. Place distal IVC
  2. Exsanguinate limb (elevate or tight wrapping)
  3. Place tourniquet proximally
  4. Remove bandage
  5. Inject lidocaine and allow to sit
  6. Remove catheters and tourniquet
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15
Q

What are some IVRA complications?

A
  1. Pain
  2. Ischemia/nerve injury
  3. Limb swelling
  4. Hematoma
  5. Local anesthetic toxicity
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16
Q

What are indications for a retrobulbar block?

A
  • Enucleation
  • Eviscceration/prosthesis
  • Intraocular surgery
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17
Q

What nerves are effected in a retrobulbar block?

A

CN III, IV, V, VI, ciliary ganglion

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18
Q

What are the advantages to a retrobulbar block?

A
  1. Post-op analgesia
  2. Globe immobility during sx
  3. Decreased anesthetic and NMBD requirements
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19
Q

What are potential complications of a retrobulbar block?

A
  • Retrobulbarr hemorrhage
  • Damage to optic nerve or extraocular muscles
  • Globe penetration
  • Intravascular injection
  • Intrathecal injection
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20
Q

What is the preferred technique for a retrobulbar block?

A

Interior-temporal palpebral

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21
Q

If there is resistance to injection during a retrobulbar block, what does this indicate?

A

Needle is within the optic nerve sheath and proceeding may be fatal

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22
Q

What nerve does a maxillary nerve block affect?

A

Sensory branch of CN V

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23
Q

What areas are anesthetised in a maxillary nerve block?

A

Maxilla and teeth/soft tissues, lateral nasal mucosa

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24
Q

`What are the three techniques for a maxillary nerve block?

A
  1. Subzygomatic
  2. Maxillary tuberosity (intraoral)
  3. Infraorbital
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25
What does an infraorbital block provide anesthesia for?
3rd premolar and all teeth rostral, rostral maxilla and soft tissues
26
Where is an infraorbital nerve block placed?
Into the infraorbital foramen
27
Is an intraoral or extraoral technique perfered in cats?
Extraoral
28
What does an inferior alveolar block provide anesthesia for?
Mandibular teeth, rostral lower lip, intermandibular space
29
Where is the injection given for an inferior alveolar block?
Medial aspect of mandible adjacent to mandibular foramen
30
What other nerve may be affected in an inferior alveolar block?
Lingual nerve- loss of sensory innervation to the rostral 2/3 of tongue
31
What does a mental block provide anesthesia for?
Rostral lower lip only
32
Where is the injection places for a mental nerve block?
Over palpable middle mental foramen, intra or extraorally
33
What does an cervical paravertebral block provide anesthesia for?
Entire thoracic limb including the scapula and shoulder joint
34
Which nerves are effected in a cervical paravetebral block?
Ventral branches of C6, C7, C8, T1, spinal nerves, proximal to brachial plexus
35
Are cervical paravertebral blocks commonly used?
No, very technically difficult
36
What does a brachial plexus block provide anesthesia for?
Thoracic limb below them elbow
37
Which nerves are effected in a brachial plexus block?
Suprascapular, musculocutaneous, radial, medial, and ulnar
38
Is a nerve locator preferred when performing a brachial plexus block?
Yes, but ultrasound can be used
39
What is a RUMM block used for?
Anesthesia of the distal thoracic limb including the carpus
40
Which nerves are effected by a RUMM block?
Radial, ulnar, median, and musculocutaneous | That's what RUMM stands for.....
41
T/F: RUMM blocks are achieved with one injection.
False- two injections are required, one medially and one laterally
42
T/F: Declaws are illegal in some places.
True
43
What drug is used for declaw blocks?
Bupivacaine
44
T/F: Femoral and sciatic blocks are typically performed together.
True
45
Pelvic limb blocks anesthetize what?
Pelvic limb distal to the mid-femur
46
T/F: Pelvic limb blocks are as effective as an epidural for stifle surgery.
True
47
What are some indications for using an intercostal block
Thoracotomy, rib fractures, thoracic procedures, etc
48
T/F: Intercostal blocks should be performed along the cranial aspect of the rib.
False- the VANs run along the caudal aspect
49
T/F: Intercostal blocks should be performed at the incision site and the two surrounding rib spaces.
True
50
What should the orientation of the effected side be when performing intrapleural regional blocks?
Down, because gravity. At least 20 min after injection
51
Where are epidurals most commonly places in small animals?
L-S space
52
Should epidurals be performed on awake animals?
No, heavy sedation or anesthesia is required
53
What are two options for administering an epidural?
1. Single injection | 2. Indwelling catheter
54
T/F: Epidurals can be performed with the animal in sternal or lateral recumbancy.
True- sternal is preferred
55
What is the loss of resistance technique for epidurals?
Feeling for a pop when advancing the needle- indicates you are through the ligaments
56
Is it recommended to inject air using the LOR technique to confirm placement?
No- use saline or the epidural drug
57
What is the hanging drop technique for eipdurals?
Watching for the fluid in the hub of the needle to be pulled into the space
58
What principle does the hanging drop technique work on?
The epidural space being subatmospheric pressure
59
Is the hanging drop more reliable in large or small patients?
Large
60
Are nerve locators commonly used in epidurals?
No
61
T/F: Higher volumes of injection are more likely to spread cranially.
True- risk for sympathetic blockade especially with LA drugs
62
What volume will be sufficient to reach L1?
0.2 mL/kg
63
T/F: Most commonly a local anesthetic and an opioid are used in combination in an epidural.
True- usually bupivicaine and morphine
64
T/F: Morphine produces more cranial spread and a longer duration with an epidural than using a LA alone
True- may produce anesthesia in the thoracic wall/limbs
65
What are some complications of an epidural injection?
1. Intrathecal injection 2. Neural damage/toxicity 3. Infection 4. Hypotension
66
What are some complications of epidural opioids?
Urinary retention and puritis (uncommon)

Anesthesiology (27 decks)

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