NCCAA Exam Review Local Anesthetics & Regional Anesthesia PDF
Document Details
2024
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Summary
This document appears to be a module from a review course for medical professionals, covering the topics of local anesthetics, regional anesthesia, and related procedures and knowledge of regional nerve blocks. It includes information on pharmacodynamics and pharmacokinetics for different anesthetics. The module likely has examples and details to prepare someone for practical examples related to these subjects.
Full Transcript
MODULE 9 -- LOCAL ANESTHETICS & REGIONAL ANESTHESIA I. Local Anesthetics Mass Gen p222-230 Local Anesthetics Understand pharmacology of local anesthetics A. Classes of Local Anesthetics +-----------------------------------+-----------------------------------+ |...
MODULE 9 -- LOCAL ANESTHETICS & REGIONAL ANESTHESIA I. Local Anesthetics Mass Gen p222-230 Local Anesthetics Understand pharmacology of local anesthetics A. Classes of Local Anesthetics +-----------------------------------+-----------------------------------+ | | Extremely short ½ life | | | | | | Hydrolyzed by | | | pseudocholinesterases & | | | non-specific esterases | | | | | | Clearance independent of hepatic | | | blood flow | | | | | | PABA -- inactive metabolite -- | | | exciting antigen for allergy | | | Prolonged clearance with : | | | Cholinesterase Deficiency Not | | | effected by : | | | | | | Cardiac failure | | | | | | Pregnancy | | | | | | H2 antagonists | +-----------------------------------+-----------------------------------+ | | ½ life = hours -- greater risk | | | for toxicity | | | | | | Metabolized by CYP450 in liver | | | | | | Clearance dependent on hepatic | | | blood flow & function | | | | | | Active metabolites | | | | | | Prolonged clearance with: | | | | | | Renal failure | | | | | | Hepatic failure | | | | | | H2 antagonist | | | | | | Cardiac failure Pregnancy Not | | | effected by: | | | | | | Cholinesterase deficiency | +-----------------------------------+-----------------------------------+ B. Pharmacodynamics & Pharmacokinetics of Local Anesthetics physiologic pH (7.4) Most common local anesthetics have a pKa \> normal pH (see chart below) Therefore, \24 hours | Removed prior | 2 hours | | | | to 1^st^ dose | | | | | or \> 24 hours | | +-----------------+-----------------+-----------------+-----------------+ | Thrombolytics | 10 days | 10 days | 10 days | +-----------------+-----------------+-----------------+-----------------+ | Warfarin | 3-5 days INR \< | | Same day | | | 1.3 | | | +-----------------+-----------------+-----------------+-----------------+ F. Peripheral Nerve Blocks \*\*Use the following descriptions & images included to achieve these objectives\*\* Review innervation of upper extremities Review anatomy of lower extremities -- Femoral & Sciatic Nerves (as well as branches) Review innervation of ankle & various nerves blocked Block Nerve Surgical Procedure Complications ----------------- ------- -------------------- --------------- Interscalene Supraclavicular Infraclavicular Axillary Failed block   
