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One advantage of spinal anaesthesia over general anaesthesia is that it produces good analgesia without loss of ___.
consciousness
Contraindications to spinal anaesthesia include hypotension, hypovolemia, and ___ at the injection site.
sepsis
1/122
p.10
Techniques and Uses of Local Anaesthesia

One advantage of spinal anaesthesia over general anaesthesia is that it produces good analgesia without loss of ___.

consciousness

p.12
Adverse Effects and Precautions in Local Anaesthesia

Contraindications to spinal anaesthesia include hypotension, hypovolemia, and ___ at the injection site.

sepsis

p.5
Systemic Actions and Toxicity of Local Anaesthetics

Local anaesthetics tend to produce a fall in ___ primarily due to sympathetic blockade.

BP

p.1
Comparative Features of General and Local Anaesthesia

In local anaesthesia, the area of the body involved is ___, compared to the whole body in general anaesthesia.

restricted

p.3
Mechanism of Action of Local Anaesthetics

The Na + channel has an activation gate known as the ___ gate near its extracellular mouth.

m

p.6
Pharmacokinetics of Local Anaesthetics

Amide linked LAs, such as lidocaine, are degraded only in the liver microsomes by ___ and hydrolysis.

dealkylation

p.4
Local Actions and Differential Sensitivity of Nerve Fibers

Autonomic fibres are generally more susceptible than ___ fibres.

somatic

p.3
Mechanism of Action of Local Anaesthetics

The LA receptor is located in the ___ segment of domain IV.

S6

p.3
Pharmacokinetics of Local Anaesthetics

Local anaesthetics with lower pKa (7.6–7.8) are considered ___ acting.

fast

p.7
Pharmacokinetics of Local Anaesthetics

The maximum dose of lidocaine is ___ mg.

300

p.7
Pharmacokinetics of Local Anaesthetics

Ropivacaine has a slow onset and a duration of ___ to ___ minutes.

120, 300

p.6
Individual Local Anaesthetic Compounds

Cocaine produces prominent CNS stimulation with marked effects on mood and ___.

behaviour

p.5
Systemic Actions and Toxicity of Local Anaesthetics

Bupivacaine is relatively more ___ and has produced ventricular tachycardia.

cardiotoxic

p.1
Definition and Mechanism of Local Anaesthetics

Local anaesthetics (LAs) cause reversible loss of sensory perception, especially of ___, in a restricted area of the body.

pain

p.2
Mechanism of Action of Local Anaesthetics

A resting nerve is rather resistant to ___ .

blockade

p.4
Local Actions and Differential Sensitivity of Nerve Fibers

In myelinated fibres, the critical length usually covers ___ nodes of Ranvier.

2–3

p.7
Adverse Effects and Precautions in Local Anaesthesia

The early central effects of lidocaine include drowsiness, mental clouding, and ___ .

tinnitus

p.9
Individual Local Anaesthetic Compounds

Oxethazaine provides symptomatic relief in conditions like gastritis and ___ reflux.

gastroesophageal

p.9
Adverse Effects and Precautions in Local Anaesthesia

Doses exceeding ___ mg/day of Oxethazaine may produce dizziness and drowsiness.

100

p.9
Techniques and Uses of Local Anaesthesia

The onset of action for lidocaine sprayed in the throat is ___ to ___ minutes.

2, 5

p.3
Pharmacokinetics of Local Anaesthetics

Procaine, tetracaine, and bupivacaine have higher pKa (8.1–8.9) and are considered ___ acting.

slow

p.6
Individual Local Anaesthetic Compounds

Cocaine should never be injected as it is a protoplasmic ___ and causes tissue necrosis.

poison

p.9
Techniques and Uses of Local Anaesthesia

Conduction block involves injecting LA around ___ trunks.

nerve

p.8
Mechanism of Action of Local Anaesthetics

Ropivacaine blocks A delta and C fibers more completely than A ___ fibers.

beta

p.12
Techniques and Uses of Local Anaesthesia

Epidural anaesthesia requires relatively ___ volumes of drug compared to spinal anaesthesia.

larger

p.11
Individual Local Anaesthetic Compounds

Bupivacaine for continuous epidural analgesia has a maximum dose concentration of ___ percent.

0.125

p.1
Individual Local Anaesthetic Compounds

Mepivacaine, Etidocaine, and Articaine are examples of ___ anaesthetics.

local

p.6
Pharmacokinetics of Local Anaesthetics

Ester linked LAs, like procaine, are rapidly hydrolysed by plasma ___ esterase.

pseudocholin

p.5
Systemic Actions and Toxicity of Local Anaesthetics

Drugs acting on the peripheral nervous system can enhance ___ consumption in the affected area.

oxygen

p.11
Adverse Effects and Precautions in Local Anaesthesia

One complication of spinal anaesthesia is ___ paralysis, which is rare with proper care.

respiratory

p.10
Techniques and Uses of Local Anaesthesia

Lidocaine is commonly used for shorter duration of action at a concentration of ___ to ___%.

1, 2

p.11
Adverse Effects and Precautions in Local Anaesthesia

Neurological symptoms such as pain and/or ___ in the back and lower limbs may occur after spinal anaesthesia.

paresthesias

p.9
Techniques and Uses of Local Anaesthesia

Infiltration anaesthesia involves injecting a dilute solution of LA under the ___ in the area of operation.

skin

p.9
Techniques and Uses of Local Anaesthesia

For the eye, drugs like Proparacaine and Tetracaine are used in ___ or ointment form.

drops

p.10
Techniques and Uses of Local Anaesthesia

Adding ___ to the LA can prolong spinal anaesthesia by about one-third.

adrenaline

p.8
Individual Local Anaesthetic Compounds

Tetracaine is a highly lipid soluble PABA ester that is more potent and more ___ due to slow hydrolysis.

toxic

p.12
Techniques and Uses of Local Anaesthesia

The limb is elevated to ensure venous drainage by ___ before applying the tourniquet.

gravity

p.1
Mechanism of Action of Local Anaesthetics

LAs block generation and conduction of nerve impulse at any part of the ___ with which they come in contact.

neurone

p.2
Individual Local Anaesthetic Compounds

Ester-linked LAs include ___, procaine, and tetracaine.

Cocaine

p.2
Mechanism of Action of Local Anaesthetics

As the concentration of the LA increases, the rate of rise of action potential and maximum depolarization ___ .

decreases

p.2
Mechanism of Action of Local Anaesthetics

Binding of the LA prolongs the ___ state of the sodium channel.

inactivated

p.4
Local Actions and Differential Sensitivity of Nerve Fibers

In general, smaller fibres are more sensitive than ___ fibres.

larger

p.4
Local Actions and Differential Sensitivity of Nerve Fibers

The order of blockade among somatic afferents is: pain—temperature sense—___—deep pressure sense.

touch

p.4
Adverse Effects and Precautions in Local Anaesthesia

The LA often fails to afford adequate pain control in ___ tissues.

inflamed

p.9
Techniques and Uses of Local Anaesthesia

Surface anaesthesia is produced by topical application to ___ membranes or abraded skin.

mucous

p.4
Techniques and Uses of Local Anaesthesia

Addition of a vasoconstrictor like adrenaline prolongs the duration of action of LAs by decreasing their rate of ___ from the local site.

removal

p.8
Adverse Effects and Precautions in Local Anaesthesia

Bupivacaine is more prone to prolong the ___ interval and induce ventricular tachycardia.

QTc

p.9
Techniques and Uses of Local Anaesthesia

Eutectic lidocaine/prilocaine is used for anaesthetizing ___ skin.

intact

p.12
Mechanism of Action of Local Anaesthetics

The greatest separation between sensory and motor block is obtained by using ___% bupivacaine.

0.25

p.1
Techniques and Uses of Local Anaesthesia

Cooling methods, such as application of ice or CO2 snow, can also produce ___ anaesthesia.

local

p.4
Mechanism of Action of Local Anaesthetics

Injected around a mixed nerve, local anaesthetics cause anaesthesia of skin and paralysis of the ___ muscle supplied by that nerve.

voluntary

p.3
Mechanism of Action of Local Anaesthetics

The cationic form of the local anaesthetic, ___, primarily binds to the receptor.

BH +

p.6
Adverse Effects and Precautions in Local Anaesthesia

CNS effects of systemic toxicity include light headedness, dizziness, and ___ disturbances.

auditory and visual

p.7
Techniques and Uses of Local Anaesthesia

Eutectic lidocaine/prilocaine is used to anaesthetise intact skin after ___ application.

surface

p.10
Techniques and Uses of Local Anaesthesia

Field block anaesthesia is produced by injecting the LA ___ in a manner that all nerves coming to a particular field are blocked.

subcutaneously

p.11
Adverse Effects and Precautions in Local Anaesthesia

Cauda equina syndrome is a very rare complication resulting in prolonged loss of control over ___ and ___ sphincters.

bladder, bowel

p.5
Systemic Actions and Toxicity of Local Anaesthetics

At high doses, local anaesthetics can induce cardiac ___ and prolong the effective refractory period.

arrhythmias

p.12
Individual Local Anaesthetic Compounds

Lidocaine (1–2%) and ___ (0.25–0.5%) are popular drugs for epidural anaesthesia.

bupivacaine

p.12
Mechanism of Action of Local Anaesthetics

The spread of the local anaesthetic in the epidural space is governed by the ___ injected.

volume

p.12
Adverse Effects and Precautions in Local Anaesthesia

Bupivacaine should not be employed for intravenous regional anaesthesia due to its higher ___ toxicity.

cardio

p.1
Comparative Features of General and Local Anaesthesia

In general anaesthesia, the site of action is the ___, while in local anaesthesia it is peripheral nerves.

CNS

p.2
Individual Local Anaesthetic Compounds

Amide-linked LAs, such as lidocaine, are not hydrolysed by ___ esterases.

plasma

p.2
Mechanism of Action of Local Anaesthetics

The predominant active species of a LA is the ___ form which binds more avidly to the activated and inactivated states of the channel.

cationic

p.3
Mechanism of Action of Local Anaesthetics

In the resting state, the activation gate of the Na + channel is ___.

closed

p.6
Adverse Effects and Precautions in Local Anaesthesia

The maximal safe dose of LAs is lower in patients with ___ disease.

hepatic

p.11
Adverse Effects and Precautions in Local Anaesthesia

Hypotension in spinal anaesthesia is primarily due to blockade of ___ vasoconstrictor outflow.

sympathetic

p.4
Adverse Effects and Precautions in Local Anaesthesia

Inflammation lowers the pH of the tissue, leading to a greater fraction of the LA being in the ___ form.

ionized

p.6
Individual Local Anaesthetic Compounds

Cocaine is a natural alkaloid from the leaves of ___ coca.

Erythroxylon

p.9
Techniques and Uses of Local Anaesthesia

Infiltration anaesthesia is used for minor operations like incisions and ___ repair.

hernia

p.11
Techniques and Uses of Local Anaesthesia

Epidural anaesthesia involves injecting local anaesthetic into the ___ space.

spinal dural

p.8
Individual Local Anaesthetic Compounds

Dibucaine is the most potent, most toxic, and longest acting local anaesthetic used on less delicate ___ membranes.

mucous

p.7
Individual Local Anaesthetic Compounds

Cocaine is indicated for ___ anaesthesia.

ocular

p.7
Individual Local Anaesthetic Compounds

Procaine was introduced in ___ and is not used now.

1905

p.6
Pharmacokinetics of Local Anaesthetics

Procaine is negligibly bound to plasma proteins, but amide LAs are bound to plasma ___ acid glycoprotein.

α 1

p.3
Mechanism of Action of Local Anaesthetics

The local anaesthetic receptor is located within the channel in its ___ half.

intracellular

p.6
Adverse Effects and Precautions in Local Anaesthesia

Cardiovascular toxicity of LAs can manifest as bradycardia, hypotension, and ___.

cardiac arrhythmias

p.6
Adverse Effects and Precautions in Local Anaesthesia

Injection of LAs may be painful, but local tissue toxicity is generally ___.

low

p.6
Adverse Effects and Precautions in Local Anaesthesia

Hypersensitivity reactions to LAs are more common with ___ linked LAs.

ester

p.3
Local Actions and Differential Sensitivity of Nerve Fibers

Clinically used local anaesthetics block sensory nerve endings, nerve trunks, and ___ junctions.

neuromuscular

p.8
Adverse Effects and Precautions in Local Anaesthesia

The concentration of bupivacaine that is contraindicated due to cardiac arrest is ___%.

0.75

p.10
Techniques and Uses of Local Anaesthesia

The primary site of action for spinal anaesthesia is the ___ in the cauda equina.

nerve roots

p.10
Techniques and Uses of Local Anaesthesia

The level of sympathetic block in spinal anaesthesia is about ___ segments higher than the level of cutaneous analgesia.

2

p.11
Techniques and Uses of Local Anaesthesia

In thoracic epidural anaesthesia, the local anaesthetic is injected in the ___ region.

midthoracic

p.8
Individual Local Anaesthetic Compounds

Proparacaine is a meta amino benzoic acid derivative that is faster acting than ___.

tetracaine

p.2
Mechanism of Action of Local Anaesthetics

The mechanism of action of LAs involves decreasing the entry of ___ ions during the upstroke of action potential.

Na+

p.7
Individual Local Anaesthetic Compounds

Lidocaine blocks conduction within ___ minutes when injected around a nerve.

3

p.5
Systemic Actions and Toxicity of Local Anaesthetics

At safe clinical doses, synthetic local anaesthetics produce little apparent ___ effects.

CNS

p.3
Mechanism of Action of Local Anaesthetics

The degree of blockade by local anaesthetics is ___ dependent, with greater blockade at higher frequencies of stimulation.

frequency

p.5
Mechanism of Action of Local Anaesthetics

The basic action of all local anaesthetics is ___ inhibition.

neuronal

p.10
Techniques and Uses of Local Anaesthesia

Nerve block anaesthesia involves injecting the LA around the appropriate ___ or ___ to achieve a larger area of anaesthesia.

nerve trunks, plexuses

p.10
Techniques and Uses of Local Anaesthesia

The latency of anaesthesia for lidocaine can be as quick as ___ minutes for intercostal nerves.

3

p.10
Techniques and Uses of Local Anaesthesia

Spinal anaesthesia is injected in the subarachnoid space between ___ and ___.

L2, L3

p.11
Adverse Effects and Precautions in Local Anaesthesia

Nausea and vomiting after spinal anaesthesia are more common following ___ operations.

abdominal

p.8
Local Actions and Differential Sensitivity of Nerve Fibers

Ropivacaine has a lower lipid solubility, making it less likely to penetrate large myelinated ___ fibers.

motor

p.11
Individual Local Anaesthetic Compounds

Lidocaine used for spinal anaesthesia has a concentration of ___ to ___ percent.

1.5, 5

p.12
Adverse Effects and Precautions in Local Anaesthesia

Deflation of the tourniquet in less than ___ minutes may allow toxic amounts of the local anaesthetic to enter systemic circulation.

15

p.2
Chemistry of Local Anaesthetics

Clinically useful local anaesthetics (LAs) are weak bases with ___ property.

amphiphilic

p.7
Individual Local Anaesthetic Compounds

Lidocaine is currently the most widely used ___ anaesthetic.

local

p.9
Individual Local Anaesthetic Compounds

Oxethazaine is unique because it ionizes to a very small extent even at ___ pH values.

low

p.3
Mechanism of Action of Local Anaesthetics

The neuronal Na + channel is a ___ KD glycoprotein composed of a large α and two small β subunits.

300

p.7
Individual Local Anaesthetic Compounds

Prilocaine has lower CNS toxicity due to larger volume of distribution and ___ clearance.

faster

p.5
Systemic Actions and Toxicity of Local Anaesthetics

The early neurological symptoms of overdose with lidocaine include ___ numbness and dizziness.

circumoral

p.7
Individual Local Anaesthetic Compounds

Bupivacaine is a more lipophilic and more potent long-acting ___ linked local anaesthetic.

amide

p.11
Adverse Effects and Precautions in Local Anaesthesia

Headaches after spinal anaesthesia may occur due to seepage of ___.

CSF

p.12
Techniques and Uses of Local Anaesthesia

Lumbar epidural anaesthesia produces anaesthesia of the ___, pelvis, and hind limbs.

lower abdomen

p.5
Pharmacokinetics of Local Anaesthetics

Pharmacokinetic characteristics of local anaesthetics are not important determinants of their ___ but influence their systemic effects.

efficacy

p.10
Techniques and Uses of Local Anaesthesia

Spinal anaesthesia is preferred for operations on the lower limbs, pelvis, and lower abdomen, such as ___ and ___ procedures.

prostatectomy, caesarean

p.8
Adverse Effects and Precautions in Local Anaesthesia

Benzocaine can cause ___ when absorbed, due to its very low aqueous solubility.

methaemoglobinemia

p.1
Mechanism of Action of Local Anaesthetics

When a LA is applied to a mixed nerve, it results in muscular paralysis and loss of ___ control.

autonomic

p.1
Comparative Features of General and Local Anaesthesia

In general anaesthesia, consciousness is ___, while in local anaesthesia it remains unaltered.

lost

p.1
Comparative Features of General and Local Anaesthesia

Local anaesthesia is usually ___ needed for the care of vital functions.

not

p.4
Mechanism of Action of Local Anaesthetics

Local anaesthetics reduce the release of ___ from motor nerve endings.

acetylcholine

p.6
Pharmacokinetics of Local Anaesthetics

Local anaesthetics enter highly perfused organs such as the brain, heart, liver, and ___, followed by muscle and other viscera.

kidney

p.4
Local Actions and Differential Sensitivity of Nerve Fibers

Epidural bupivacaine produces sensory block at much lower concentration than that needed for ___ block.

motor

p.5
Systemic Actions and Toxicity of Local Anaesthetics

Cocaine is a powerful CNS stimulant causing a sequence of effects including ___, excitement, and mental confusion.

euphoria

p.8
Techniques and Uses of Local Anaesthesia

Bupivacaine is popular in obstetrics because it allows for analgesia without significant ___ blockade.

motor

p.8
Pharmacokinetics of Local Anaesthetics

Due to its high lipid solubility, bupivacaine distributes more in ___ than in blood after spinal/epidural injection.

tissues

p.12
Techniques and Uses of Local Anaesthesia

The injection for caudal anaesthesia is given in the ___ canal through the sacral hiatus.

sacral

p.8
Individual Local Anaesthetic Compounds

Levobupivacaine is the S(–) enantiomer of bupivacaine, which is equally potent but less ___ and less prone to cause seizures.

cardiotoxic

p.12
Pharmacokinetics of Local Anaesthetics

The onset is slower and duration of anaesthesia is longer with ___ compared to lidocaine.

bupivacaine

p.5
Pharmacokinetics of Local Anaesthetics

Rate of absorption of local anaesthetics depends on the ___ to the area of application.

blood flow

p.12
Techniques and Uses of Local Anaesthesia

Intravenous regional anaesthesia involves injecting the local anaesthetic in a large vein of a ___ occluded limb.

tourniquet

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