Principles of Regional Anaesthesia Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the mechanism of action for local anesthetics in regional anesthesia?

Increasing the rate of potassium efflux across the nerve membrane, raising the firing threshold

Prevention of sodium influx across the nerve membrane, decreasing the rate and amplitude of depolarization (correct)

Inhibiting the release of acetylcholine at the neuromuscular junction, causing muscle paralysis

Blocking calcium channels in the nerve membrane, preventing action potential propagation

Which of the following is an absolute contraindication for regional anesthesia?

Severe anatomic distortion

Coagulopathy

Neuropathy

Patient refusal (correct)

Which of the following local anesthetics is known for its differential blockade and lower cardiotoxicity?

Prilocaine

Lignocaine

Bupivacaine (Marcain)

Ropivacaine (Naropin) (correct)

Which of the following conditions is considered a relative contraindication for regional anesthesia?

Sepsis Signup and view all the answers

Which of the following pre-operative assessments is NOT specific to regional anesthesia?

Determination of the patient's blood type Signup and view all the answers

Which of the following conditions is considered a potential difficulty for regional anesthesia?

All of the above Signup and view all the answers

What is the endpoint for identifying the epidural space using the 'loss of resistance' technique?

Epidural space Signup and view all the answers

Which of the following is a common advantage of performing a regional anesthesia technique using a plexus block?

Ability to provide a large area of anesthesia with a relatively large dose of local anesthetic Signup and view all the answers

What is the recommended site for performing a spinal or epidural anesthetic block?

Below the L2/L3 intervertebral space Signup and view all the answers

Which of the following is a potential complication associated with the administration of local anesthetics?

Local anesthetic toxicity Signup and view all the answers

What is the primary purpose of using a continuous regional anesthesia technique, such as a continuous brachial plexus or femoral nerve block?

To provide prolonged anesthesia or analgesia Signup and view all the answers

Which of the following is a potential complication associated with the use of peripheral nerve blocks?

Transient or chronic paresthesia Signup and view all the answers

What is the primary advantage of using topical anesthesia, such as EMLA cream, for certain procedures?

Technically easy to administer with minimal equipment Signup and view all the answers

What is the primary purpose of performing a sensory blockade assessment with ice or pin prick during a regional anesthesia procedure?

To determine the extent of sensory blockade Signup and view all the answers

Which of the following is a recommended prevention strategy to minimize the risk of local anesthetic toxicity during a regional anesthesia procedure?

Perform frequent aspiration checks during the local anesthetic injection Signup and view all the answers

What is the primary purpose of post-regional anesthesia management strategies, such as keeping the weak and insensate limb in a sling or padded?

To protect the limb from injury due to the loss of sensation and motor function Signup and view all the answers

Study Notes

Mechanism of Action

Local anesthetics work by blocking the conduction of nerve impulses in regional anesthesia
They bind to sodium channels in nerve membranes, reducing the influx of sodium ions and preventing depolarization

Contraindications

Absolute contraindication for regional anesthesia: patient refusal
Relative contraindication: pre-existing neurological deficits, local infection, bleeding disorders, and anticoagulant therapy

Local Anesthetics

Differential blockade and lower cardiotoxicity: lidocaine
Advantage of lidocaine: it can be used for cardiac arrhythmias and has a rapid onset and short duration

Pre-Operative Assessments

NOT specific to regional anesthesia: laboratory tests (e.g., complete blood count, electrolytes)
Important assessments for regional anesthesia: coagulation status, platelet count, and neurological examination

Difficulties and Complications

Potential difficulty: patient anxiety or claustrophobia
Potential complication associated with local anesthetics: systemic toxicity, allergic reactions, and methemoglobinemia
Potential complication associated with peripheral nerve blocks: nerve damage, hematoma, and infection

Techniques

Endpoint for identifying the epidural space using the 'loss of resistance' technique: feeling a sudden decrease in resistance as the needle enters the epidural space
Recommended site for performing a spinal or epidural anesthetic block: lumbar region (L2-L5)
Advantage of plexus block: can provide anesthesia for a larger area with a single injection

Continuous Regional Anesthesia

Primary purpose: to provide prolonged postoperative analgesia and reduce opioid requirements
Advantage: can reduce the risk of chronic pain and facilitate early mobilization

Topical Anesthesia

Primary advantage: provides superficial analgesia for minor procedures, reducing the need for injectable anesthetics
Example: EMLA cream

Sensory Blockade Assessment

Primary purpose: to evaluate the effectiveness of regional anesthesia and adjust the block as needed
Methods: ice or pinprick test

Prevention of Local Anesthetic Toxicity

Recommended strategy: use a test dose, monitor for signs of toxicity, and have resuscitation equipment available

Post-Regional Anesthesia Management

Primary purpose: to prevent injury and promote patient comfort
Strategies: keep the weak and insensate limb in a sling or padded, and provide adequate pain management and monitoring

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the principles of regional anaesthesia including mechanism of action, advantages, disadvantages, types of regional anaesthesia, potential complications, and post-RA care.