Questions and Answers
What is regional anesthesia?
Regional anesthesia can provide prolonged postoperative pain relief.
True
List one relative indication for regional anesthesia.
To avoid the dangers of general anesthesia.
The dose required in Bier's block is about ______ mg/kg of 0.5% plain solution of lidocaine or prilocaine.
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Match the following types of anesthesia with their description:
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Patients with crush injury to the limb should not receive IVRA.
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What should be prepared before administering a local anesthetic?
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Study Notes
Overview of Regional Anesthesia
- Local anesthetics are used to block pain sensations in a large body area without inducing unconsciousness.
- Provides effective operating conditions and prolonged postoperative pain relief, supporting rehabilitation and early function return.
Indications for Regional Anesthesia
- Avoids risks associated with general anesthesia, such as difficult intubation and respiratory failure.
- Patient requests for regional techniques are valid considerations.
- Aids in high-quality postoperative pain management.
- Part of rehabilitation strategies for quick return to normal function.
Contraindications for Regional Anesthesia
- Not suitable for uncooperative or agitated patients.
- Some psychiatric conditions may pose a risk.
Pre-Administration Preparation
- Essential equipment includes:
- Indwelling intravenous cannula and tilting table or trolley.
- Opportunities for intermittent positive pressure ventilation (IPPV) with oxygen.
- Monitoring devices: ECG, noninvasive blood pressure, pulse oximetry, and end-tidal CO2.
- Suction apparatus and catheters.
- Tranquilizers, induction agents, muscle relaxants, atropine, and pressor agents like ephedrine.
- Crystalloid and colloid solutions for infusion.
- Complete resuscitation gear, including a defibrillator.
Types of Regional Anesthesia
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Peripheral Nerve Blocks:
- Involves direct injection of local anesthetic near a nerve to inhibit pain sensation in the nerve's supply area.
- Commonly utilized for surgeries on limbs, face, and groin.
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Intravenous Regional Anesthesia (Bier’s Block):
- Ideal for short procedures on distal limbs (below the elbow or knee).
- Involves exsanguination of the extremity and application of a tourniquet before introducing the anesthetic intravenously.
- The typical duration of the procedure is limited to 40 minutes to avoid tourniquet pain.
- Dosage: 3-4 mg/kg of 0.5% plain lidocaine or prilocaine; bupivacaine is contraindicated due to cardiotoxicity.
Contraindications for Bier’s Block
- Not suitable for crush injuries, may cause tissue damage due to hypoxia.
- Conditions such as Reynaud's disease, sickle cell anemia, and scleroderma also limit its application.
Ultrasound-Guided Regional Anesthesia (USGRA)
- Initiated in the mid-1990s at the University of Vienna, USGRA enhances the precision of peripheral nerve block by visualizing structures with ultrasound.
- This novel application improves the efficacy and safety of nerve block procedures compared to traditional methods.
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Description
Explore the principles of regional anesthesia in this quiz on the 3rd stage of anesthesia. Learn how local anesthetics can block pain in specific body regions while keeping the patient conscious. Test your knowledge on the applications and benefits of regional anesthesia methods.
