Peripheral Nerve Blocks Flashcards Preview

AP: Cumulative > Peripheral Nerve Blocks > Flashcards

Flashcards in Peripheral Nerve Blocks Deck (41):
1

What class of drug includes bupivacaine, lidocaine, mepivacaine, prilocaine, and ropivacaine?

Amides

2

What is the maximum dose and duration for bupivacaine?

Max dose = 3 mg/kg
duration = 1.5 to 8 hours

3

What is the maximum dose and duration for lidocaine?

Max dose = 4.5 mg/kg (7 w epi)
duration = 0.75 to 2 hours

4

What is the maximum dose and duration for mepivacaine?

Max dose = 4.5 mg/kg ( 7 w epi)
duration = 1 to 2 hours

5

What is the maximum dose and duration for ropivacaine?

Max dose = 3 mg/kg
duration = 1.5 to 8 hours

6

What drug can be added to lidocaine in mepivacaine to prolong their action?

Epinephrine

7

Benzocaine, chloroprocaine, cocaine, procaine, and tetracaine all fall into what category of drugs?

Esters

8

It is more common to have an allergic reaction to amides or esters? why?

Esters
PABA

9

A toxic dose of benzocaine can cause what?

Met hemoglobinemia

10

How is met hemoglobinemia treated?

Methyline blue

11

Why is epinephrine added to local anesthetics?

Intravascular marker
improves quality of block
decreases absorption (prolong action)
vasoconstriction on surgical field

12

What are the three major risks of nerve blocks?

Systemic toxicity
infection
peripheral nerve damage

13

What is LAST?

Local anesthetic systemic toxicity

14

Which CNS symptoms come first C&S excitation or CNS depression?

CNS excitation

15

What are the cardiovascular effects of LAST?

Depression of myocardial conduction and contractility

production of arterial vasodilatation

16

How can LAST be prevented?

Incremental injection
Frequent aspiration
Adding a marker
Limiting local anesthetic dose and concentration
Communication with the patient

17

How is LAST treated?

Seizures: Versed, propofol, thiopental
Cardio/pulmonary symptoms: airway management
ACLS/BLS
Intralipid infusion
CP Bypass

18

How is Intralipid administered?

1.5 mL/kg as an initial bolus followed by .25 mL/kg/min for 30 to 60 minutes

19

Name three techniques for placement of blocks

Ultrasound technique
Peripheral nerve stimulator
Paresthesia technique

20

The brachial plexus stems from what roots?

C5-8, T1

21

Name the five main branches of the brachial plexus?

Musculocutaneous
axillary
Radial
median
Ulnar

22

Name the three main nerves or groups of nerves that are in Close proximity to the brachial plexus

Superficial cervical plexus
Phrenic nerve
Intercostal brachial nerve

23

What are the main approaches to the brachial plexus?

Interscalene
Supraclavicular
Infraclavicular
Axillary

24

What type of block is most commonly done for shoulder, humorous and clavicle procedures?

Interscalene block

25

What area is commonly missed by an interscalene block?

C8-T1 ulnar nerve

26

In what patients would you be most concerned with the possibility of phrenic nerve palsy?

Ascites
Pregnant
COPD
Respiratory depression
Oxygen dependent
Obese

27

What type of block would you perform for surgeries for the entire arm below the level of the shoulder?

Supraclavicular block

28

Supraclavicular blocks are performed at what level of the brachial plexus?

At the level of the divisions

29

What type of block is performed at the level of the cords and is indicated for elbow forearm and hand surgery?

Infraclavicular

30

What type of block is performed at the level of the terminal branches for elbow forearm and hand surgery?

Axillary

31

How is a bier block performed?

By inserting IV catheter distally, inflating a double pneumatic tourniquet, wrapping the arm in eschmark elastic bandages and injecting 50mL of 0.5% lidocaine

32

What type of block would be performed for surgery on the hip anterior thigh and knee?

Lumbar plexus block

33

What nerves does the lumbar plexus block cover?

Femoral nerve
Lateral femoral cutaneous nerve
Obturator nerve

34

The femoral nerve is medial or lateral to the artery?

Lateral

35

Femoral nerve blocks are performed for what types of surgeries?

Knee surgeries
Femoral ORIF
Surgery involving the medial aspect of the leg

36

What is the largest sensory branch of the femoral nerve?

Saphenous nerve

37

What is the largest nerve of the leg?

Sciatic nerve

38

The sciatic nerve is composed of what 2 nerves?

Tibial nerve and common peroneal nerve

39

What are the two common approaches to a sciatic nerve block?

Popliteal fossa and subgluteal

40

What type of block is performed for foot and toe surgeries?

Ankle block

41

Which nerves are blocked in the ankle block?

Deep peroneal
Superficial peroneal
Posterior tibial
Sural
Saphenous