Chapter 9 Topical, Local, and Regional Anesthesia
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Created by:
hmeustice on November 19, 2011
Subjects:
surgical technology, chapter 9, pharmacology, anesthesia, drugs, topical, local, regional
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24 terms
Terms | Definitions |
|---|---|
 topical anesthesia | involves the placement of a nerve conduction blocking agent onto a tissue layer; provides anesthesia on mucous membranes of upper aerodigestive tract, urethra, vagina, rectum, and skin; administered by the surgeon; achieved by cryoanesthsia or pharmacological agent |
| Cryoanesthesia | involves the reduction of nerve conduction/transmission by localized cooling; accomplished with ice or use of cryoanesthesia machine; freezes superficial nerve endings blocking nerve impulses and eliminating pain |
| Pharamceutical agents | applied directly to thes kin and are absorbed and come in contact with peripheral nerve endings providing anesthesia by preventing the initiation of the nerve impulses; Lidocaine and cocaine two examples |
| Local anesthesia | involves the injection of a nerve conduction blocking agent into the tissues surrounding a peripheral nerve or nerves that serve only the tissue at the site of surgical intervention |
| Monitored Anesthesia Care | MAC; involves a combination of nerve conduction blockade on the topical or local level that is supplemented with analgesics, sedatives, or amnesics; surgeon commonly performs nerve conduction blockade |
| Regional Anesthesia/blockade | involves the administration of an anesthetic usually by the anesthesia provider along amajor nerve tract; blocks conduction from all tissues distal to the injection site; ex: nerve plxus block, Bier block, spinal block, epidural block |
| Nerve plexus block | usually accomplished with the injection of an anesthetic solution in an area of a major plexus; resulting anesthsia includes all tissue innervated by the plexus |
| Bier block | provides anesthesia to the distal portion of the upper extremity by injecting a large volume of low concentration anesthetic agent into a vein at a level below a tourniquet |
| 2nd tourniquet inflated | after local anesthetic starts working and first tourniquet deflated |
| Bier block used | on interventions of the extermity of 1 hour duration or less |
| Spinal Block | spinal anesthsia or intrathecal block; injection of an anesthetic agent into the cerebrospinal fluid in subarachnoid space between the meningeal layers of the spinal cord to provide loss of sensation to entire body below the diaphragm |
| Spinal anesthesia onset | effect seen in 3-10 minutes; lasts approximately 1-1 and 1/2 hours |
| Patient cooperation | critical to the successful administration of spinal anesthsia, often sedated prior to needle placement |
| Position | patient usually positiioned in the latera or sitting position; the goal is to expose the intervertebral spaces to allow for needle placement |
| agent baricity | refers to teh specific gravity of the anestehtic solution in comparision to CSF |
| hyperbaric solutions | high specific gravity; tend to settle toward gravity |
| hypobaric solution | low specific gravity; tend to float or move away from gravity |
| isobaric solutions | solutions with the same specific gravity as CSF |
| Rate of injection | affects the agents placement; rapid injection will promote turbulence as it combines iwth CSF; causes it to spread over a larger area of nerve roots resulting in increased area of effect |
| increased CSF pressure | may reult from the position of the OR table, coughing, straining, or muslce contraction; may result in migration of the anesthetic agent and unintended contact with nerve roots controlling major body functions |
| Spinal Anesthetic Agents | most commonly used agent is tetracaine hydrochloride; lidocaine hydrochloride and procaine hydrochloride also used |
| Spinal Anesthetic Additives | epinephrine; intrathecal opioid |
| Advantages of spinal anesthesia | patient remains conscious and in control of their airway; nonirritating to respiratory trea; produces bowel contraction faciliating exposure; excellent muscle relaxant |
| Disadvantages and Complications of SPinal Anesthesia | induced hypotension; nausea or vomiting; no dosage control once administered; spinal headache; can develop temorary or permanent paralysis |
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