WorksheetsRegional anesthesia complications
Total questions: 21
Worksheet time: 4mins
What is the recommended first-line treatment for severe cardiovascular collapse due to LAST?
Initiate ACLS and give 1mg epinephrine bolus
Initiate ACLS and start 20% lipid emulsion
Initiate ACLS and give Calcium carbonate to stabilize myocardium
Initiate ACLS and treat ventriculate arrhythmia with Class I antiarrhythmics
Which of the following is typically the earliest sign of local anesthetic systemic toxicity?
Hypotension
Grand-mal seizure
Perioral numbness
New onset leg weakness
When administering lipid emulsion therapy for LAST, which of the following dosing strategies is correct?
1.5 mL/kg bolus followed by 0.25 mL/kg/min infusion
0.5 mL/kg bolus followed by 1 mL/kg/min infusion
3 mL/kg bolus only, no infusion
Continuous infusion at 2 mL/kg/min for 30 minutes, no bolus
Which of the following is the most common early clinical sign of a spinal epidural abscess?
Localized back pain
Fever, back pain, and neurologic deficits
New onset leg weakness
Acute urinary retention
What is the imaging modality of choice when an epidural hematoma is suspected following neuraxial anesthesia?
CT scan of the spine without contrast
CT scan of the spine with contrast
MRI spine
X-ray thoracolumbar spine
Urgent surgical decompression for an epidural hematoma is most effective when performed within what time window after the onset of symptoms?
6 hours
12 hours
24 hours
48 hours
Which local anesthetic is most strongly associated with the development of transient neurologic symptoms after spinal anesthesia?
Bupivacaine
Ropivacaine
Lidocaine
Tetracaine
Which of the following best describes the typical presentation of transient neurologic symptoms?
Persistent lower-extremity weakness beginning within 24 hours after neuraxial block
Urinary retention and saddle anesthesia beginning within 24 hours after neuraxial block
Sharp radicular pain with motor deficits beginning within 24 hours after neuraxial block
Severe back and leg pain beginning within 24 hours after neuraxial block
Which factor increases the risk of developing transient neurologic symptoms following spinal anesthesia?
Combined spinal-epidural technique
The use of intrathecal opioids
The use of intrathecal clonidine
Lithotomy positioning after spinal anesthesia
Which of the following is the earliest sign of high spinal anesthesia?
Severe hypotension with bradycardia
Difficulty breathing or a sense of dyspnea
Loss of consciousness
Arm weakness or numbness
What is the correct equation for Mean Arterial Pressure, which can help to explain the hemodynamic compromise seen following spinal anesthesia?
MAP = CO x SV x SBP
MAP = SVR x HR x AoDP
MAP = SV x HR x SVR
MAP = CO x SVR x AoDP
Which of the following is the initial step in management for a patient with suspected total spinal anesthesia?
Prepare for emergent intubation and vasoactive support
Administer high-dose intralipid infusion
Place the patient upright to reduce cephalad spread
Inject sterile saline into the intrathecal space
Which factor is most strongly associated with an increased risk of peripheral nerve injury after a regional block?
Using peripheral nerve stimulator instead of ultrasound guidance
Performing the block under sedation with fentanyl and versed
Using epinephrine-containing local anesthetic solutions
Using high pressure injection in the absence of paresthesia
Which of the following is the recommended initial management for a patient with suspected nerve injury after a peripheral nerve block?
Neurology consultation and nerve conduction study
High dose perineural dexamethasone injection
Reassurance and proper documentation
Prescribe oral gabapentin
Which of the following is the best initial management for a patient with symptomatic postoperative urinary retention?
Encourage oral hydration
Perform bladder scan and catheterization
Prescribe oral tamsulosin
Observe for 6–8 hours without intervention
Which of the following patient factors is most strongly associated with an increased risk of post–dural puncture headache?
Obesity
Male Sex
Pregnancy
Older age
What is the characteristic feature of a post–dural puncture headache?
Unilateral throbbing pain that worsens with brushing teeth
Bilateral headache relieved when sitting up
Bilateral headache relieved when lying flat
Unilateral headache worsened with bright light
Which of the following is the most appropriate initial treatment for PDPH?
IV hydration
IV Ketorolac
Epidural blood patch
Sphenopalentine ganglion block
Tie breaker 1: Andrew's son recently turned 1 year old. His name is...
Henry
William
Graham
Oliver
Tie breaker 2: Andrew's wife, Chloe, recently started as an attending with which NCH group?
Pediatric nephrology
Pediatric critical care
Pediatric emergency medicine
Pediatric cardiology
Tie breaker 3: Andrew is originally from which Kentucky town?
Lexington
Owensboro
Bowling Green
Louisville
