Local Anesthetics

Review!

Dropdown

Local anesthetics can be used in conjunction to ​

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pain control and ​

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the dose of general anesthetic required.

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Multiple Choice

What is local anesthetic that we use here at Oulton College for our incisional line blocks?

• Ropivacaine

• Bupivacaine

• Procaine
• Lidocaine

Multiple Choice

What are tetracaine and proparacaine used for?

• Ophthalmic procedures.

• General anesthetics.

• Used to treat infections.

• Muscle relaxants.

Review!

19-24

Multiple Select

Which neurons are affected by local anesthetics?

Select 2

• The brain.

• The peripheral nervous system

• The spinal cord

Multiple Choice

Do local anesthetics cross the placenta?

• Yes

• No

Multiple Choice

Local anesthetics have many side effects.

• True

• False

Multiple Choice

Do local anesthetics have a sedative effect?

• Yes, they can induce sleep.

• They have a mild calming effect.
• No sedative effect.

Multiple Choice

Why might local anesthetics be preferable in veterinary patients with high risk cardiovascular or respiratory issues?

• Have no effect on pain relief.

• Reduce systemic risks and provide targeted pain relief.

• They are only used in emergency situations.

Multiple Select

What areas should local anesthetics not be used? (select 3)

• Infected tissue

• Tooth root

• Areas with significant fat

• Tendons

• Intradermal

Review!

To slide 32

Reorder

Put the mechanism of local anesthetic in order:

• Small amount of local anesthetic is deposited near sensory neuron.

• Sodium channels are blocked.

• Nerve depolarization cannot happen.

• Results in nerve unable to conduct an electrical impulse (cannot communicate pain message to the brain)

1

2

3

4

• 1
• 2
• 3
• 4

Multiple Choice

How are local anesthetics eliminated by the body?

• Through sweat glands.

• Hepatic metabolism and renal excretion.

• Eliminated via exhalation.

Match

Match the following

• Paresis

• Ataxia

• Paralysis

• Motor neuron

Partial loss of voluntary movement

Lack of coordination

Loss of muscle function

Degeneration of motor neurons

• Partial loss of voluntary movement

• Lack of coordination

• Loss of muscle function

• Degeneration of motor neurons

Review!

Multiple Choice

How long does it take a topical anesthetic to take affect when applied directly to the skin?

• Immediately upon application

• At least 10 minutes

• 1 to 2 hours
• 5 to 10 seconds

Multiple Choice

With an epidural block, are patients able to move their pelvic limbs?

• Yes

• Limited movement.

• No.

Multiple Choice

What might we see with a sympathetic blockade?

• Decreased heart rate and blood pressure, vasodilation, and altered sweating.
• Enhanced digestion and salivation
• Vasoconstriction and increased sweating
• Increased heart rate and blood pressure

Review!

Multiple Choice

What type of block are we using when we spray a cat's laryngeal folds with lidocaine?

• Splash block

• Line block

• Nerve block

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Multiple Choice

In which of the following situations would we use an infiltration local anesthetic on our veterinary patients?

• To increase analgesia when removing a small skin tumour.

• To block the nerves prior to a leg amputation.

• To increase analgesia prior to debriding an infected laceration.

Review!

To slide 53

Multiple Choice

What does epinephrine do when it is included with lidocaine for local anesthesia?

• It decreases the risk of infection.

• It prolongs the effect of lidocaine.

• It speeds incision healing.

• It treats ventricular arrhythmias when given IV.

Multiple Choice

In which of the following scenarios would lidocaine/epinephrine local block be best used in our veterinary patients?

• During dental cleanings.

• As a line block for a spay.

• As an epidural for a cow.

• Removing a dermal tumour on the abdomen.

Do folks need a brief break?

Review!

Dropdown

Lidocaine has a ​

Select answer

onset.

Bupivacaine has a ​

Select answer

onset, but lasts ​

Select answer

.

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Multiple Choice

For a nerve block, should we deposits the local anesthetic into the nerve itself?

• No. The anesthetic should be injected into the bloodstream

• No. The needle should not touch the nerve.

• Yes. The needle must touch the nerve directly

Review!

Open Ended

List 1-2 examples of a nerve block.

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Multiple Choice

What is a benefit of using nerve blocks?

• Increased risk of infection.
• Longer recovery time.
• Permanent nerve damage.
• Reduced need for systemic pain medications.

Review!

Multiple Choice

Where would you use a ring block in a veterinary surgery?

• In surgeries involving the abdomen of animals.
• For dental procedures in animals.
• In surgeries involving the limbs or digits of animals.

Review!

Multiple Select

Which of the following is an example of regional anesthesia?
Select 2 that apply.

• Hoof block to check lameness in a horse.

• Epidural.

• Brachial plexus block.

• Spraying lidocaine on laryngeal folds.

Review!

Multiple Choice

What is scoliosis?

• A type of arthritis affecting the spine.
• A disease that causes the spine to become shorter.
• An abnormal lateral curvature of the spine.

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Open Ended

What is an example of a class of patients where epidural anesthesia is best used?

Review!

87-93

Match

Match the following.

• Lasts 1-2 hours.

  Used for immobility and anesthesia for surgery.

• Lasts up to 6 hours.

  Used for immobility and anesthesia for surgery.

• Used for post-operative analgesia.

Lidocaine

Bupivicaine

Opioids like morphine

• Lidocaine

• Bupivicaine

• Opioids like morphine

Multiple Choice

Where are epidural medication deposited?

• Muscle tissue
• Subarachnoid space
• Epidural space
• Intravenous system

Multiple Choice

What is the cauda equina?

• A muscle in the lower back, useful for injecting pre-medications prior to surgery.

• A type of medical imaging technique used for spinal cord injury.

• A bundle of spinal nerves at the termination of the spinal cord.

Multiple Choice

What fluid surrounds the spinal cord?

• Cerebrospinal fluid

• Interstitial fluid
• Lymphatic fluid
• Synovial fluid

Multiple Choice

For most animals, what at the landmarks for giving an epidural injection?

• Thoracic vertebrae and scapula landmarks.
• Lumbar vertebrae (L7) and sacrum.

• Cervical vertebrae and clavicle landmarks.

Multiple Choice

What risk is there in using epidurals for cats?

• Epidurals are always safe for all cats.
• Epidurals can enhance a cat's energy levels and are used to treat feline allergies.

• The spinal cord of cats may extend to S1, so slight risk of entering subarachnoid space.

Drag and Drop

Using a local anesthetic like lidocaine for an epidural will block both ​

Placeholder

and motor neurons, so an animal may be unable to walk.

Opioids used as an epidural have minimal effect on ​

Placeholder

neurons.

Drag these tiles and drop them in the correct blank above

sensory

motor

pressure

cerebral

Review!

Multiple Choice

What is a Bier block?

• A regional anesthesia technique for limb surgeries.

• A method for diagnosing infections.

• A surgical tool used for cutting.

Multiple Choice

For a Bier block, what local anesthetic do we use?

• Lidocaine

• Morphine

• Bupivacaine

• Procaine

Review!

Multiple Choice

What is the benefit of lidocaine being administered via CRI to healthy, anesthetized animals?

• Improved analgesia and reduced opioid and GA requirements

• Increases heart rate in anesthetized animals.

• Has no effect on pain management in anesthetized animals.

Review!

Match

Match the following:

• Paresis

• Paralysis

• Paresthesia

• Ataxia

Muscle weakness

Loss of muscle function

Abnormal sensations

Lack of coordination

• Muscle weakness

• Loss of muscle function

• Abnormal sensations

• Lack of coordination

Review!

Open Ended

How can we help ensure we do NOT give an overdose of a local anesthetic to our patient?

Last 2 questions:

Categorize

Options (12)

Pelvis

Brain

Anal sac removal

Lung Lobectomy

Amputation of right hind limb

Heart surgery

Thyroidectomy

Chest tube insertion

Tail

Amputation of right forelimb

Urethrostomy

Tail amputation

Categorize the following body parts and veterinary surgeries into those where Epidurals are useful vs. Non-epidural (where we don't use them).

Epidural

Non-epidural

Open Ended

What happens if an epidural medication infiltrates the thoracic spinal cord.

What should we do is this happens?

Would this be a great question on Test #2?