Regional-anesthesia-head-neck-slides-060524

Regional-anesthesia-head-neck-slides-060524 - Regional...

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Unformatted text preview: Regional Anesthesia In Otolaryngology University of Texas Medical Branch Dept. of Otolaryngology Jacques Peltier MD Francis Quinn MD May 24, 2006 1 Advantages of Local Anesthesia • • • • • • The patient is conscious during surgery. Smooth postoperative course. Patient awake and maintains his own airway. Less pain needs less narcotics, lighter anesthesia in general cases. Less nursing care after procedures, less admissions. Less expensive 2 Disadvantages of Local Anesthesia • • • The patient may prefer to be asleep Specialized skill necessary. Some blocks require up to 30 minutes to be fully effective. • Analgesia may not always be totally effective, and general anesthesia may be required anyway. 3 Disadvantages of Local Anesthesia • Generalized toxicity may occur if local anesthetic drugs are given intravenously by mistake or an overdose is given. • Widespread sympathetic blockade can result in hypotension. • There is a small but definite incidence of prolonged nerve damage. 4 Local Anesthetics • • • • • • Agent: Lidocaine with epi (1 or 2%) Lidocaine without epi Mepivacaine without epi (3%) Bupivacaine with epi (0.5%) Articaine with epi (4.0%) Dose: 7mg/kg 4.5mg/kg 5.5mg/kg 1.3mg/kg 7mg/kg Onset/Duration: Fast/medium Fast/short Fast/short Long/long Fast/medium *ADULT DOSES IN PATIENTS WITHOUT CARDIAC HISTORY 5 Scalp Blocks 6 Scalp Blocks 7 Scalp Blocks 8 Scalp Blocks 9 Scalp Blocks 10 Trigeminal Nerve Blocks 11 Gasserian Ganglion Block 12 Mandibular Nerve Blocks 13 Mandibular Nerve Blocks 14 Mandibular Nerve Blocks 15 Mandibular Nerve Blocks 16 Mandibular Nerve Blocks 17 Mandibular Nerve Blocks 18 Mandibular Nerve Blocks 19 Mandibular Nerve Blocks 20 Mandibular Nerve Blocks 21 Mandibular Nerve Blocks 22 Mandibular Nerve Blocks 23 Inferior Alveolar Nerve Block 24 Inferior Alveolar Nerve Block 25 Inferior Alveolar Nerve Block 26 Inferior Alveolar Nerve Block 27 Inferior Alveolar Nerve Block 28 Inferior Alveolar Nerve Block 29 30 31 Mental Nerve Block 32 Mental Nerve Block 33 Mental Nerve Block 34 Maxillary Nerve Blocks 35 Maxillary Nerve Blocks 36 Maxillary Nerve Blocks 37 Maxillary Nerve Blocks 38 Maxillary Nerve Blocks 39 Maxillary Nerve Blocks 40 Local Blocks 41 Supraorbital Nerve Blocks 42 Supratrochlear Nerve Blocks 43 Infraorbital Nerve Blocks 44 Nasociliary and Anterior Ethmoidal Nerve Blocks 45 Local Blocks for Nasal Surgery 46 Maxillary Nerve Blocks 47 48 49 50 Local Blocks for Nasal Surgery 51 52 53 54 Local Ear Blocks 55 Local Ear Blocks 56 Local Ear Blocks 57 Local Ear Blocks 58 Local Ear Blocks 59 Cervical Blocks 60 Cervical Blocks 61 Cervical Blocks 62 Cervical Blocks 63 Cervical Blocks 64 Cervical Blocks 65 Cervical Blocks 66 Spinal Accessory Nerve Block 67 Glossopharyngeal Nerve Block 68 Glossopharyngeal Nerve Block 69 Glossopharyngeal Nerve Block 70 Glossopharyngeal Nerve Block 71 Airway and Laryngeal Blocks 72 Laryngeal Anesthesia 73 Laryngeal Anesthesia 74 Laryngeal Anesthesia 75 Laryngeal Anesthesia 76 Laryngeal Anesthesia 77 Laryngeal Anesthesia 78 Laryngeal Anesthesia 79 Laryngeal Anesthesia 80 Laryngeal Anesthesia 81 Laryngeal Anesthesia 82 Laryngeal Anesthesia 83 Special thanks to Melinda Quinn for help in scanning slides used in this presentation. 84 References • Atlas of Regional Anesthesia, Katz et. al, Multiple pages, • • • Appleton and Lange 1994 Techniques of Regional Anaesthesia, Scott et. al, Appleton and Lange, 1989 Regional Anesthesia of the oral cavity, Jastak and yagiela, The Mosby Company 1981 Illustrated Handbook in Local Anaesthesia, Eriksson, W.B. Saunders Company 1979 85 ...
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