Local Anesthesia
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Created by:
JWTruthGirl on January 26, 2010
Description:
LA Exam One
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40 terms
Terms | Definitions |
|---|---|
 Analgesia | Loss or reduction of pain |
| Nerve Block | Close proximity to nerve trunk; remote |
| Field Block | Close proximity to larger terminal nerve branches |
| Local Infiltration | Flooding |
| First Local Anesthetic | Cocaine |
| Ester-Linked LA | No longer used |
| Amide-Linked LA | Lidocaine; used in dentistry today |
| Free Base Form of Amide-Linked LAs | Penetrates nerve membrane and dissociates into ionized form |
| Ionized LA Action | Blocks nerve conduction by blocking influx of Na+ preventing an action potential |
| Local Anesthetic Qualities | Weak base= Low water solubility, unstable, poor diffusion |
| Need for HCl in LA | Improves water solubility, is stable, and has good diffusion |
| Minimum Anesthetic Concentration/Cm | Individual susceptibility of each nerve fiber to the effects of LA |
| Sequence of Disappearance of Sensations | Pain-Temperature-Touch-Proprioception-Motor Function |
| pKa | pH at which 50% of the drug is ionized |
| Lower pKa Values= | Most rapid onset LAs |
| Potency Determined By | Lipid Solubility |
| All LA Are | Vasodilators |
| Caine Potency Sequence | Bupivi-Etido-Pro-Lido-Mepivi-Prilo-Arti |
| Duration Determined By | Protein-Binding Capacity |
| CNS Adverse Effects | Convulsions and general CNS depression |
| CV Adverse Effects | Contractile force |
| What predominates following an epinephrine injection? | Alpha Effects |
| As epinephrine decreases... | Beta effects predominate and vasodilation occurs |
| Epinephrine Effects | Increases HR, contractility, vasoconstriction/dilation |
| Epinephrine Dosing for Healthy Individual | 3 micrograms/kg not to exceed .2mg |
| Epinephrine Dosing for CV Disease Pt with No Limitations | 1.5 micrograms/kg not to exceed .1mg |
| Epinephrine Dosing for CV Disease Pt with Limitations | .75 micrograms/kg not to exceed .04mg |
| Tricyclic Antidepressant Considerations | Increased BP and dysrhythmyia; No more than 36 micrograms of epinephrine |
| Beta-Adrenergic Antagonists Considerations | Increased BP and bradycardia; No more than 36 micrograms of epinephrine |
| General Anesthetic Considerations | Halothane= No Epinephrine |
| Cocaine Considerations | No epinephrine |
| Alpha-Adrenergic Receptor Blockers | Hypotension and vasodilation; Minimum quantity possible |
| ASA I | Healthy |
| ASA II | Mild systemic disease with no limitations |
| ASA III | Severe systemic disease with limitations |
| ASA IV | Incapacitating disease with a constant threat to life |
| ASA V | Moribund |
| 4.5-7micrograms/mL Epinephrine | Euphoria, sweating, vomiting |
| 7.5-10 micrograms/mL Epinephrine | Increased HR, BP, and respiration; Drowsiness and LOC |
| 10 micrograms and up Epinephrine | Seizures, Decreased HR, BP, and respirations |
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