Anesthetic Techniques & Equipment Usage Flashcards
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Read the first 7 Anesthetic Techniques & Equipment Usage flashcards as text
Which patient is the poorest candidate for an interscalene brachial plexus block?
Answer: A patient with severe COPD who depends on full diaphragmatic function
Interscalene blocks cause ipsilateral phrenic nerve palsy in nearly all patients, which can cause respiratory failure in patients with severe lung disease.
Per ASRA guidance for local anesthetic systemic toxicity in a patient over 70 kg, what is the initial 20% lipid emulsion dose?
Answer: 100 mL bolus over 2-3 minutes, then about 200-250 mL infusion over 15-20 minutes
ASRA recommends a 100 mL bolus followed by an infusion for patients over 70 kg, or 1.5 mL/kg and 0.25 mL/kg/min for patients under 70 kg.
During resuscitation for local anesthetic systemic toxicity, how should epinephrine dosing be modified?
Answer: Use doses of 1 mcg/kg or less
Small epinephrine doses are preferred because high doses can impair lipid rescue and worsen arrhythmias.
A patient receiving prophylactic enoxaparin 40 mg once daily needs a neuraxial block. Per ASRA, what is the minimum interval after the last dose?
Answer: 12 hours
ASRA recommends waiting at least 12 hours after a prophylactic LMWH dose and 24 hours after a therapeutic dose.
With a hyperangulated videolaryngoscope, the glottis is clearly seen but the endotracheal tube cannot be advanced. What is the most useful adjunct?
Answer: A rigid stylet shaped to match the blade curvature
Hyperangulated blades give a view around the corner, so a matching rigid stylet is needed to steer the tube to the glottis.
Which feature distinguishes the i-gel supraglottic airway from the classic LMA?
Answer: It has a non-inflatable thermoplastic elastomer cuff
The i-gel's gel-like cuff molds to the perilaryngeal anatomy without inflation.
Which needle choice most reduces the risk of post-dural puncture headache after spinal anesthesia?
Answer: Pencil-point needle such as a Whitacre or Sprotte
Pencil-point needles separate dural fibers rather than cutting them, which lowers the rate of headache.