Ester Local Anesthetics — Flashcards

Flashcard 1: Symptoms such as metallic taste, perioral numbness, visual changes, twitching, and seizures in a patient on local anesthesia point towards _____

Answer: local anesthetic systemic toxicity (LAST)

Flashcard 2: Ropivacaine has a _____ duration of action than bupivacaine

Answer: shorter

Flashcard 3: Administration of 20% _____ therapy is considered at first signs of local anaesthesia systemic toxicity (LAST), after airway management

Answer: lipid emulsion

Flashcard 4: Bupivacaine has a tendency to provide more _____ block over motor block (sensory/motor)

Answer: sensory

Flashcard 5: Neurotoxicity from neuro-axial (epidural or spinal) placement of local anesthetic solution is maximum with _____

Answer: lidocaine

Flashcard 6: _____ 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 7: Alkalinization of local anesthetics can lead to a _____ onset of action and improved quality of block

Answer: faster

Flashcard 8: Stapedotomy is preferred to be done under _____ anaesthesia

Answer: local

Flashcard 9: Which local anesthetics are considered safe for use in patients with **malignant hyperthermia**?

Answer: All local anesthetics (both amides and esters) :: Historically, amides were thought to trigger MH and esters (like procaine) were preferred; however, all LAs are now confirmed to be safe.

Flashcard 10: 2 mL of 1% _____ in 18 mL propofol can be used to decrease pain on injection of propofol

Answer: lidocaine