Pharmacology
A 45-year-old woman is undergoing ultrasound-guided interscalene block for shoulder arthroscopy. The anesthesiologist is using bupivacaine with epinephrine. Shortly after injection, the patient complains of a metallic taste in her mouth and becomes confused. She develops circumoral numbness followed by twitching of her facial muscles. Regarding local anesthetics in orthopaedic surgery:
Mark each as TRUE or FALSE
Local anesthetics block sodium channels, preventing nerve conduction; they are classified as amides ...
Lidocaine has rapid onset and intermediate duration (1-2 hours), while bupivacaine has slower onset ...
Local anesthetics block potassium channels; esters are metabolized by the liver; ester anesthetics h...
Local anesthetic systemic toxicity (LAST) presents with CNS symptoms first (metallic taste, circumor...
Peripheral nerve blocks provide excellent analgesia for orthopaedic procedures; ultrasound guidance ...
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Click T (True) or F (False) for each option