Intra-Operative Discussion Topics for Regional Anesthesia Rotation

 

 

1.                  Physiology of nerve conduction and the mode of action of local anesthetics.

 

2.                  Biotransformation and excretion mechanisms of local anesthetics.

 

3.                  Differences between amide and ester local anesthetics in allergic potential.

 

4.                  Understand the physiological effects of pKa, lipid solubility, and protein binding on local anesthetics.

 

5.                  Determinants (dosage, disease condition, site of injection) of blood concentrations of local anesthetics.

 

6.                  Toxicities (CNS, cardiac, respiratory, preservatives, fetal) of local anesthetics and the appropriate management of these toxic responses.

 

7.                  Selection criteria of local anesthetics and their additive effects for peripheral nerve blocks.

8.                  Physiochemical properties (dosage, toxic dose, onset of action, duration of action) of each local anesthetic.

 

9.                  Different ways to shorten the onset and prolong the duration of action of local anesthetics.

 

10.              General indications and contraindications of peripheral nerve blocks.

 

11.              Understand the theory behind the use of nerve stimulator and how to localize nerve based on field strength and evoked contraction.

 

12.              Selection of appropriate nerve block for a specific surgical procedure.

 

13.              Cutaneous and dermatomal innervation of the brachial plexus for upper extremity nerve blocks.

 

14.              Cutaneous and dermatomal innervation of the lumbarsacral plexus for lower extremity nerve blocks.

 

15.              Advantages and disadvantages between neuroaxial and peripheral nerve block for lower extremity surgery

 

16.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of interscalene block.

 

17.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of supraclavicular block.

 

18.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of infraclavicular block.

 

19.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of axillary block.

 

20.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of sciatic block.

 

21.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of femoral (3-in-1) block.

 

22.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of lateral femoral cutaneous block.

 

23.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of obturator block.

 

24.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of ilio-inguinal block.

 

25.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of popliteal fossa block.

 

26.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of ankle block.

 

27.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of intercostal block.

 

28.              Indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of paravertebral block.

 

29.              Mechanism, agents, indications, contraindications, techniques/approaches, pitfalls, and complications (and their treatments) of Bier block.