Chemistry and Mechanism of Action — Flashcards

Flashcard 1: Highest blood concentrations of local anesthetic are seen after IV injection f/b _____ injection

Answer: tracheal

Flashcard 2: Commercially available local anaesthetic solutions have an acidic pH in order to maximize the stability, hence should be _____ before use

Answer: alkalinized

Flashcard 3: _____ acting local anesthetics are preferred for prolonged pain relief, such as in brachial plexus block

Answer: Long

Flashcard 4: Ropivacaine has a _____ duration of action than bupivacaine

Answer: shorter

Flashcard 5: Bupivacaine has a tendency to provide more _____ block over motor block (sensory/motor)

Answer: sensory

Flashcard 6: Administration of 20% _____ therapy is considered at first signs of local anaesthesia systemic toxicity (LAST), after airway management

Answer: lipid emulsion

Flashcard 7: Alkalinization of local anesthetics can lead to a _____ onset of action and improved quality of block

Answer: faster

Flashcard 8: Neurotoxicity from neuro-axial (epidural or spinal) placement of local anesthetic solution is maximum with _____

Answer: lidocaine

Flashcard 9: _____ 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.