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31 Cards in this Set
- Front
- Back
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Which are easier to block. C fibers or Aa?
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C (small and slightly mylenated); as opposed to A, which is large and mylenated
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orders of block
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pain/temp; autonomic (blood temp); muscle tone,touch and pressure (c section feels pressure/pulling);motor/reflex
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3 main factors we consider when choosing a drug for epidural
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drug, concentraiton, volume
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factors we consider in chosen drug for epidural
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onset and duration of action.
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what does concentration determine?
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density/analgesia or anesthesia
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The higher the concentration the
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more the density, the more the more block, more towards anesthesia.
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volume of local determines the
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spread
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sensory dermatome for shoulder/clavicle
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C3-C5
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sensory dermatome for thumb index
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C6-C7
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Inner forearm
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T1-T2
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nipple
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T-4
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Tip of xyphoid process
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T6
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dermatome for Umbilicus
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T10
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dermatome for Inguinal ligament
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T12
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dermatome for Knee and dorsal thigh
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L3/L4
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dermatome for Lateral foot
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S1
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Perineum dermatome
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S2-S4
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which locals does epi prolong?
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lidocaine, chloroprocaine, mepivicaine
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Does epi prolong bubivicaine?
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no
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how long does epi prolong lidocaine and bubivicaine?
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40-80 min
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two dermatome regressin (min)sensory blocks for lidocaine and mepivicaine/complete resolution
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60-100min; 160-200min
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duration of bubivicaine 2 dermatome regression/complete resolution
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120-240;300-460
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Topical locals
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cocaine, benzocaine
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short acting locals
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procaine, 2-chloroprocaine
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medium acting locals
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lidocaine, mepivicaine,prilocaine
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max dosage of lidocaine w/ and w/out epi
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4.5 mg/kg; w/epi: 7mg/kg
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long duration locals
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bubivacaine,robivacaine, levobubivaine, etiocaine
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for labor epidural, only want
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analgesia to keep motor function, so use lower concentration of bubivacaine (.25%)
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does lidocaine or bubivacaine block more motor?
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lidocaine
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If we want anesthesia and analgesia lumbar placement what should we use?
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higher concentraion than with just aanalgesia, so .5%bubiviaine 12cc; lidocaine 2%12cc
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if we want flail chest analgesia with mid throacic placement (t6-t7)
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.15% bubivicaine, 10cc
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