L.A.S.T.
We use this medication for treatment of LAST (local anesthetic systemic toxicity)
What is intralipid or lipid emulsion 20%?
This block is ulnar-sparing.
What is interscalene block?
Injury to this nerve hinders plantar flexion and inversion.
What is tibial nerve?
Nerves blocked in TAP
What are the ilioinguinal, iliohypogastric, and subcostal nerves?
The amount of time that prophylactic SQH should be held prior to neuraxial procedure.
What is 4-6 hours
Perioral numbness, metallic taste, tinnitus, blurry vision, tremors, agitation, seizures
What are the typical symptoms of central nervous system toxicity?
This block covers lateral, medial and posterior cords of the brachial plexus.
What is infraclavicular block?
Blocking this nerve will numb the lateral foot.
What is sural nerve?
Shamrock sign or muscle landmarks for QL3 (aka anterior QL or transmuscular QL) block
What are psoas major, QL, and erector spinae
The amount of time that apixaban should be held prior to neuraxial procedure.
72 hours
We avoid these medications when treating LAST.
What are local anesthetics, beta blockers, calcium channel blockers and vasopressin?
We do this block to cover the sensory articular branches of the sciatic nerve (popliteal plexus) without causing motor deficit.
What is IPACK (infiltration between the popliteal artery and capsule of the knee)?
The anterior/posterior boarders of paravertebral space
What is pleura and costotransverse ligament
The amount of time that plavix should be held prior to neuraxial procedure.
5-7 days
For a 70 kg patient, we bolus 100ml intralipid over 2-3 minutes and infuse the medication at this rate.
250 ml over 15-20 minutes
or
0.25 ml/kg/min
When we block the brachial plexus using axillary approach, we block this additional nerve to cover the lateral forearm.
What is musculocutaneous nerve?
We can do this block in addition to adductor canal block and IPACK to manage pain from medial meniscus repair.
What is obturator nerve block?
Where is LA injected during PECS I and II blocks
PECS I: Between pectoralis major and minor
PECS II: PECS I as well as between pectoralis minor and serratus anterior
The difference in time between holding prophylactic dose enoxaparin vs. treatment dose enoxaparin prior to neuraxial procedure.
12 hours
This is the weight-based dose of epinephrine we use to resuscitate a LAST patent.
< or = 1 mcg/kg Epinephrine
The sensation of the lateral aspect of the 4th digit (palmer) is covered by this nerve.
What is median nerve?
The lateral boarder of the adductor canal.
What is vastus medialis?
Lower extremity weakness after a QL block
What is LA spread to the lumbar plexus
Absolute contraindications to neuraxial
What are patient refusal, infection at the needle insertion site, elevated ICP, hypovolemia/hypotension, and allergy
Relative contraindications include: coagulopathy (abnormal labs), sepsis, fixed cardiac output (AS), indeterminate or preexisting neurological disease