Local Anesthetic Toxicity Indian Medical PG Flashcards - Medical Study Cards
Master Local Anesthetic Toxicity with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
Local Anesthetic Toxicity Flashcard Deck - 10 Cards
Flashcard 1: The next best step in the management of vasospasm and gangrene following accidental intra-arterial thiopental administration is to leave the needle in place and administer _____ via the same needle.
Answer: Lidocaine (or Procaine) and Heparin
Extra: Management of accidental intra-arterial thiopental injection:
1. Leave the needle in place (in situ).
2. Dilute the drug with **Normal Saline**.
3. Relieve vasospasm with **Lidocaine**, **Procaine**, or **Papaverine**.
4. Prevent thrombosis with **Heparin**.
5. Sympathetic block (e.g., Stellate ganglion block) to maintain vasodilation.
Note: Thiopental is highly alkaline (pH 10.5). Intra-arterial injection causes immediate vasospasm and endarteritis, which can lead to gangrene.
Flashcard 2: A sudden fall in EtCO2 with hypotension along with normal airway pressure during surgery is suggestive of _____.
Answer: CO2 embolism
Flashcard 3: The most common anaphylactic agent during anesthesia is _____
Answer: antibiotics
Flashcard 4: What is a major life-threatening anesthesia-related complication in patients with Duchenne muscular dystrophy?
Answer: Anesthesia-induced rhabdomyolysis (AIR) and Hyperkalemia
Extra: Patients with Duchenne muscular dystrophy (DMD) are at risk of Anesthesia-Induced Rhabdomyolysis (AIR) when exposed to triggering agents (volatile anesthetics or succinylcholine). This leads to acute, life-threatening hyperkalemia and potential cardiac arrest.
Note: While the clinical presentation is similar, DMD is no longer considered a risk factor for classic Malignant Hyperthermia (MH). The two conditions have different genetic and pathophysiological bases.
Flashcard 5: _____ is the mainstay rx for cardiac arrest due to bupivacaine
Answer: Intravenous Lipid Emulsion (ILE) / Intralipid
Extra: Lipid Emulsion Therapy (20% Intralipid) is the mainstay for cardiac arrest due to Local Anesthetic Systemic Toxicity (LAST), specifically bupivacaine.
Note: Standard ACLS is modified in LAST. Avoid vasopressin and use only low-dose epinephrine (<1 mcg/kg), as high doses can impair resuscitation and reduce the efficacy of lipid emulsion.
Flashcard 6: A drastic fall in etCO2 with hypotension during neck surgery is most likely due to _____.
Answer: venous air embolism (VAE)
Flashcard 7: The following capnography waveform represents:
_____
Answer: malignant hyperthermia
Flashcard 8: The following capnographic waveform is suggestive of _____:
Answer: Malignant hyperthermia
Flashcard 9: Tuberculin syringe 1ml or insulin syringe _____units, without fixed needle x3 are one of the components of the anaphylaxis kit
Answer: 40
Flashcard 10: Malignant hyperthermia is usually related to a defect in _____ receptors, which causes increased Ca2+ release from the SR
Answer: ryanodine
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