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17 Cards in this Set
- Front
- Back
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Which two pharmacologic agents are most commonly used as local anesthetics?
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Lidocaine (Xylocaine)
Bupivacaine (Marcaine) |
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What is the purported mechanism of action of lidocaine and bupivacaine?
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Not definitively known but thought to be Na+ channel blockade
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What's the clinical difference between lidocaine and bupivacaine?
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Pharmacokinetic difference
Lidocaine has quick onset and short duration Marcaine has moderate onset and long duration. |
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Which LA has quick onset and short duration?
Which has moderate onset and long duration? |
Lidocaine fast
Marcaine slower and longer-lasting |
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What is Xylocaine?
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Lidocaine
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What is Marcaine?
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Bupivacaine
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In what concentrations is bupivacaine commonly available?
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0.1%, 0.5%, 0.75%
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How do you convert percent concentrations to mass concentrations?
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Multiply by ten
For example: 0.1% bupivacaine is 1 mg/mL 0.25% bupivacaine is 2.5 mg/mL 0.75% bupivacaine is 7.5 mg/mL |
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What is the onset of lidocaine?
What is the duration of lidocaine? |
30s to 2m
0.5-3h |
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What is the onset of bupivacaine?
What is the duration of bupivacaine? |
5-40m
3-12h |
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What is the dose of bupivacaine without epinephrine?
What is the dose of bupivacaine with epinephrine? |
2 mg/kg
2-3 mg/kg |
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In which three concentrations is bupivacaine commonly available?
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0.1%, 0.5%, 0.75%
In other words, 1 mg/mL, 5 mg/mL, 7.5 mg/mL |
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Name 5 neurologic signs/symptoms of LA toxicity.
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1) Perioral numbness
2) Metallic taste 3) Tinnitus 4) Seizures 5) Decreased LOC/coma |
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What is the dose of lidocaine without epinephrine?
What is the dose of lidocaine with epinephrine? |
5 mg/kg
7 mg/kg |
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Which two organ systems would be most affected by rising intravascular concentrations of Na+ channel blockers?
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Nervous system
Cardiovascular system |
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Name 3 CVS complications of LA toxicity.
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Bradycardia
Hypotension Arrhythmia |
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What are the complications of LA?
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Three categories:
1) Toxicity -CNS: perioral numbness, copper taste, tinnitus, seizures, decreased LOC -CVS: bradycardia, hypotension, arrhythmia 2) Inadvertent/undesirable motor or autonomic blockade -motor: inability to ambulate -autonomic: CVS and respiratory dysregulation 3) Complications secondary to trauma -injury to nerve -injury to nearby organ (e.g. pneumothorax) -post-dural headache -hematoma -abscess -infection (including meningitis for epidurals and spinals) |
