ANESTHESIA - REGIONAL ANESTHESIA CASES

ANESTHESIA ELECTIVE SELF-ASSESMENT AND STUDY QUESTIONS

Consider the following regional anesthesia cases

1. A colleague of yours from the ER calls and tells you he wants to infiltrate a large leg wound with local anesthetic to suture. He wants to know how much lidocaine he can use (pt is 70kg). How much bupivicaine? What sorts of problems would you expect with a local anesthetic overdose? What properties of lidocaine would make it a better or worse medicine than bupivicaine to infiltrate? Should he use epinephrine containing solutions?
2. How does a spinal anesthetic differ from an epidural anesthetic? What are the risks associated with each? What are the benefits of a regional vs. general anesthesia?
3. Would you perform a spinal on a patient who is on coumadin? What about someone who was on a therapeutic heparin dose and 6 hours prior to coming to the OR it was discontinued? What are your concerns in the anticoagulated patient?
4. While performing an axillary block using the trans-arterial approach, the patient begins to shake wildly. What would cause this? How would you treat the patient?