Local Anesthetics

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Local anesthetics also called

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regional anesthetic

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general definition of local anesthesia:

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renders a specific portion of the body insensitive to pain without major reduction of CNS function and level of consciousness

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Local anesthetic action is:

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interfering with nerve transmission in specific areas of the body,blocking nerve conduction only in the area in which they are applied without casing loss of consciousness

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uses of local anesthesia included:

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childbirth
dental procedures
wound suturing
chronic pain
spinal anesthesia
diagnostic procedures

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topical anesthetics are:

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applied directly to the skin and mucous membranes

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Parental anesthetics are:

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administered intravenously or by various spinal injection techniques

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intraspinal anesthesia is administered by two injection techniques; they are:

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intrathecal and epidural

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injection of anesthetic into the subarachroid space used for patients undergoin major abdominal or limb surgery

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intrathecal anesthesia

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injection of anesthetic into the subarachroid space used for patients undergoin major abdominal or limb surgery

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intrathecal anesthesia

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injection of anesthetic via a small catheter into the epidural space without puncturing the dura. commonly used to reduce labor pains.

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epidural anesthesia

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small amounts of anesthetic solution are injected into the tissue that surrounds the operative site. used or wound suturing and dental surgery.

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Infiltration

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anesthetic solution is injected at the site where a nerve innervates a specific area such as tissue used for cancer pain/orthopedic pain

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nerve block

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Local anesthesia block which ions:

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sodium, calcium, potassium

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autonomic activity is affected ______.

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first

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motor activity is lost _____.

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last

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all nerve function is restored in what order:

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the opposite order ei: motor then autonomic

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which two neurotransmitters of the sympathetic nervous system does anesthesias block:

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epinephrine and noepinephrine

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the blockade of epinephrine and noepinephrine cause cardiac effects such as:

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decreased stroke volume
cardiac output
peripheral resistance

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Name the vasoconstrictors:

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epinephrine
noepinephrine
phenylephrine

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vasoconstrictors help _____
the local anesthesia to the injected area

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confine

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Name the routes of infiltration for regional anesthesia:

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intradermal
subcutaneous
submucosal

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one complication of spinal anesthesia is:

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spinal headache

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Name the ester type anesthesias:

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benzocaine
chloroprocaine
cocaine
procaine
proparacaine
propoxycaine
tetracaine

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Name the amide type anesthesias:

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bupivacaine
dibucaine
etidocaine
lidocaine
mepivacaine
prilocaine

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epinephrine is coadministered to reduce the changes of:

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toxicity if systemically absorbed
and keep the anesthesia at the site of action

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drug drug interaction of anesthesia with __,___,___ can lead to dysrhythmias

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enflurane
halothan
epinephrine

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NMBA'S are:

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neuromuscular blocking agents

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these prevent nerve transmission in certain muscles, leadine to paralysis of the muscles.

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NMBA's

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NMBA's require mechanical ventilation because these drugs:

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paralyzes the respiratory and skeletal muscles

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Nondepolarizing NMBA's prevent ____ from acting at neuromuscular junctions

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acetylcholine

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Nondepolarizing NMBA's prevent ____ from acting at neuromuscular junctions

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acetylcholine

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muscle spasms that affect the hands,feet and face the term is:

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muscle fasciculations

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what NMBA reduces muscle fasciculations:

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succinylcholine

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succinylcholine is antagonist by blocking:

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acetylcholine

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Name the anticholinesterase drugs that are antidotes to reverse muscle paralysis

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neostigmine
pyridostigmine
edrophonium

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Name the anesthesia that relieves muscle soreness an adverse effect of succinylcholine

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sevoflurane

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NMBA's release histamine which can result in:

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bronchospasm
hypotension
excessive bronchial and salivary secretion

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cardiac adverse effects could be but are seldom seen are:

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decreased blood pressure and heart rate

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the main therapeutic use of NMBA's is:

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maintaining controlled ventilation during surgical procedures

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Contraindications of NMBA's are:

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Hx of malignant hyperthermia
penetrating eye injuries
narrow angle glaucoma

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adverse effects of succinylcholine

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hypokalemia
dysrhythmias
fasciculations
muscle pain
myoglobinuria
intraocular pressure
intragastic pressure
intacranial pressure
malignant hyperthermia

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genetically linked adverse metabolic reaction to general anesthesia that includes a rapid rise in body temperature,tachycardia,tachypnea and muscular rigidity

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malignant hyperthermia

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malignant hyperthermia is seen primarly in :

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children or adolescents

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aminoglycoside antibiotics interact with NMBA's, how?

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additive effects
inhibit acetylcholine

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tetracycline interact with NMBA'S, how?

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produce neuromuscular blockade and inhibit calcium

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A commonly used, long-acting, nondepolarizing neuromuscular blocking agent(NMBA)

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PANCURONIUM

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Anesthetic drugs that alter the central nervous system(CNS), resulting in loss of consciousness and deep muscle ralxation, are termed

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general

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____ anesthetics are applied directly to the skin and mucous membranes

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Topical

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Drugs used in combination with anesthectics to control the adverse effects of anesthetics

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Adjunctive

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Drugs that render a specific portion of th body insensitive to pain without affecting consciousness are called ____ anesthetics

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Local

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An anticholinergic drug given preoperatively to dry secretions

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Atropine

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A broad term for drugs that depress the CNS

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Anesthetics

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Anesthetics administered directly into the CNS by various spinal injection techniques are examples of ____ anesthetics

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parenteral

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the practice of using combinations of drugs to produce general anesthesia rather than using a single drug

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balanced

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Examples of adjunctive drugs used with anesthesia include which of the following:

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Sedatives-hypnotics
Anticholinergics
Opioids

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Lidocaine is frequently used for:

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Local anesthesia

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The nurse monitoring a patient after surgery keeps in mind that the primary concern with use of an NMBA is:

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respiratory arrest

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To decrease the possibility of a headache after spinal anesthesia, the nurse should instruct the patient to do

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Lie flat in bed