Techniques of Local Anesthesia Administration

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Questions and Answers

What is the route of administration for topical anesthesia?

Injection into the epidural space of the spinal cord

Direct injection into tissue

Injection into the cerebral spinal fluid

Application to mucous membranes (correct)

Which type of anesthesia is used to block sensation in a limb or a large area of the face?

Infiltration anesthesia

Nerve block anesthesia (correct)

Topical anesthesia

Spinal anesthesia

Which type of anesthesia is most commonly used in obstetrics during labor and delivery?

Epidural anesthesia (correct)

Nerve block anesthesia

Infiltration anesthesia

Spinal anesthesia

What is the main difference between spinal and epidural anesthesia?

The route of administration Signup and view all the answers

What is the site of injection for infiltration anesthesia?

Tissue immediate to the surgical site Signup and view all the answers

What is the description of spinal anesthesia?

Injected into the cerebral spinal fluid Signup and view all the answers

What is the primary effect of general anesthetics on neurons?

Block flow of sodium into neurons Signup and view all the answers

What is the primary purpose of stage III of general anesthesia?

To relax skeletal muscles and dilate pupils Signup and view all the answers

Which type of anesthesia is used to block a specific group of nerves in a small area close to the surgical site?

Infiltration anesthesia Signup and view all the answers

What is the form of formulation for topical anesthesia?

Creams, sprays, suppositories, and lozenges Signup and view all the answers

What occurs during the excitement and hyperactivity stage of general anesthesia?

The patient may become delirious and try to resist treatment Signup and view all the answers

What is the period from the beginning of anesthesia until stage 3, or surgical anesthesia, is reached?

Induction Signup and view all the answers

What is the main characteristic of stage I of general anesthesia?

Loss of pain Signup and view all the answers

What is the final stage of general anesthesia?

Respiratory and cardiovascular paralysis Signup and view all the answers

What is the period from discontinuation of the anesthetic until the patient has regained consciousness?

Recovery Signup and view all the answers

What is the main purpose of general anesthesia?

To produce unconsciousness and lack of responsiveness to painful stimuli Signup and view all the answers

What is a characteristic of ketamine as an intravenous general anesthetic?

Rapid onset and a very slow recovery Signup and view all the answers

What is the primary use of inhaled drugs in general anesthesia?

To maintain loss of consciousness Signup and view all the answers

Which of the following is an example of an intravenous general anesthetic?

Propofol Signup and view all the answers

What is the mechanism of action of inhaled drugs in general anesthesia?

Preventing flow of sodium into neurons in CNS Signup and view all the answers

What is a common adverse effect of intravenous general anesthetics?

Dysrhythmias Signup and view all the answers

What is the purpose of adjuncts to anesthesia?

To treat anticipated side effects of anesthesia Signup and view all the answers

Which of the following is an example of an adjunct to anesthesia?

Benzodiazepine Signup and view all the answers

When can adjuncts to anesthesia be given?

Before, during, or after surgery Signup and view all the answers

What is the primary benefit of using succinylcholine during procedures?

It reduces the amount of general anesthetic needed. Signup and view all the answers

What is the expected duration of action of succinylcholine when administered IV?

2-3 minutes Signup and view all the answers

What is a potential adverse effect of succinylcholine?

Bradycardia Signup and view all the answers

Why is mechanical ventilation necessary during surgery when using succinylcholine?

To prevent complete paralysis of the diaphragm and intercostal muscles Signup and view all the answers

What enzyme breaks down succinylcholine?

Cholinesterase Signup and view all the answers

What is the onset time of succinylcholine when administered IM?

2-3 minutes Signup and view all the answers

What is the main purpose of using neuromuscular blockers in anesthesia?

To facilitate mechanical ventilation and performance of surgical procedures Signup and view all the answers

What type of neuromuscular blocker does succinylcholine belong to?

Depolarizing blocker Signup and view all the answers

What is the effect of succinylcholine on skeletal muscles?

Spasms and weakness Signup and view all the answers

What is the mechanism of action of nondepolarizing neuromuscular blockers?

Acting as antagonists to acetylcholine at the NMJ Signup and view all the answers

What is the therapeutic class of succinylcholine?

Skeletal muscle paralytic drug Signup and view all the answers

What is the pharmacologic class of succinylcholine?

Acetylcholine receptor blocking drug Signup and view all the answers

What is the initial effect of succinylcholine on muscle cells?

Depolarization Signup and view all the answers

What is the result of repeated contractions induced by succinylcholine?

Prolonged depolarization and muscle weakness Signup and view all the answers

Study Notes

Techniques for Applying Local Anesthesia

Topical anesthesia: applied to mucous membranes, including the eyes, lips, gums, and throat, using creams, sprays, suppositories, drops, and lozenges.
Infiltration anesthesia: direct injection into tissue immediate to the surgical site, where the drug diffuses into tissue to block a specific group of nerves in a small area close to the surgical site.
Nerve block anesthesia: direct injection into tissue that may be distant from the operation site, affecting nerve bundles serving the surgical area.
Spinal anesthesia: injection into the cerebral spinal fluid (CSF), affecting a large, regional area such as the lower abdomen and legs.
Epidural anesthesia: injection into the epidural space of the spinal cord, commonly used in obstetrics during labor and delivery.

General Anesthetics

Block the flow of sodium into neurons, delaying nerve impulses and reducing neural activity.
Produce unconsciousness and a lack of responsiveness to painful stimuli.

Stages of General Anesthesia

Stage I: Loss of pain, where the patient loses general sensation but may be awake.
Stage II: Excitement and hyperactivity, where the patient may be delirious and try to resist treatment.
Stage III: Surgical anesthesia, characterized by relaxation of skeletal muscles and pupil dilation.
Stage IV: Respiratory and cardiovascular paralysis, which is usually avoided during general anesthesia.

Administration of General Anesthetics

Induction: the period from the beginning of anesthesia until stage 3, or surgical anesthesia, is reached.
Maintenance: the period from stage 3 until the surgical procedure is complete.
Recovery: the period from discontinuation of the anesthetic until the patient has regained consciousness.

Intravenous General Anesthetics

Examples include ketamine, propofol, and others.
Adverse effects include allergic reactions, dysrhythmias, respiratory depression, CNS depression, shivering, headache, nausea, and vomiting.

Inhaled General Anesthetics

Examples include nitric oxide and isoflurane.
Prevent the flow of sodium into neurons in the CNS, delaying nerve impulses and reducing neural activity.
Primary use is with IV agents to maintain loss of consciousness, and used alone for dental procedures.

Adjuncts to Anesthesia

Medications given to complement the effects of general anesthesia and treat anticipated side effects.
Examples include anticholinergic, benzodiazepine, cholinergic agonists, dopamine blockers, neuromuscular blockers, opioids, and phenothiazine.

Neuromuscular Blockers

Used to cause paralysis (loss of muscular function) for surgical procedures and to facilitate mechanical ventilation.
Examples include succinylcholine (Anectine, Quelicin), mivacurium (Mivacron), and tubocurarine.

Prototype Drug: Succinylcholine (Anectine, Quelicin)

Therapeutic class: skeletal muscle paralytic drug; neuromuscular blocker.
Pharmacologic class: depolarizing blocker; acetylcholine receptor blocking drug.
Actions and uses: acts on cholinergic receptor sites at neuromuscular junctions, causing depolarization and muscle contraction, followed by paralysis.
Pharmacokinetics: onset is 0.5-1 min IV, peak is variable within minutes, and duration is 2-3 min IV.
Adverse effects: complete paralysis of the diaphragm and intercostal muscles, bradycardia, and respiratory depression.

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Description

This quiz covers different methods of administering local anesthesia, including topical, infiltration, nerve block, spinal, and epidural techniques. It also explores the formulations and descriptions of each method.