Operational Medicine Medical Education and Training

Anesthesia Pharmacology

OBJECTIVE

As a Special Forces Medic given a patient requiring anesthesia, administer anesthesia utilizing your knowledge of anesthesia pharmacology and applying the five rights (right patient, right drug, right amount, right route, right time) in accordance with JSOMTC student manual of anesthesia.

REASON

As a Special Forces Medic the probability is high that you will be the only health care provider available to administer anesthesia.

PROCEDURES

Review local/regional anesthesia pharmacology

Review anesthesia pharmacology adjuncts

Review intravenous anesthetics

Review intravenous anesthetics reversal agent

 

IV Push Medication

Anesthesia Pharmacology

MS PowerPoint
85 Slides
552 KB ppt file

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1% Lidocaine for Injection

Local/Regional Anesthetics

Lidocaine

amide type anesthetic

the most commonly used local anesthetic

rapid onset and a duration of 60-75 minutes

extended when solutions with epinephrine are used for up to 2 hours

metabolized in the liver and excreted by the kidneys.

INDICATIONS Lidocaine

used to produce local and regional anesthesia for surgical and diagnostic procedures

DOSE AND ROUTES Lidocaine

Percutaneous infiltration: 0.5%, 1.0%

Regional infiltration: 0.5%

Peripheral nerve: 1.0%, 1.5%, 2.0%

Max dose 4 mg/kg or 7 mg/kg with epinephrine

Toxic IV dose: 250 mg

ADVERSE REACTIONS, PRECAUTIONS, AND INTERACTIONS Lidocaine

contraindicated in patients with a known sensitivity to amide type anesthetics

All local anesthetics can produce CNS stimulation, depression, or both

Chloroprocaine

ester type local anesthetic

onset of action is rapid (6-12 min.) and duration of anesthesia is up to 60 min.

rapidly metabolized in the plasma.

INDICATIONS Chloroprocaine

production of local and regional anesthesia for surgical and diagnostic procedures

DOSE AND ROUTES Chloroprocaine

Local infiltration: 2.0%, 3.0% for motor block

Peripheral nerve block: 1.0%, 2.0%

Maximum dose 11 mg/kg or 13 mg/kg with Epinephrine

Toxic IV dose: 450 mg

ADVERSE REACTIONS, PRECAUTIONS, AND INTERACTIONS Chloroprocaine

contraindicated in patients with known hypersensitivity to drugs of the PABA ester group

All local anesthetics can produce CNS stimulation, depression, or both

Procaine

ester type local anesthetic

slower onset of action than Lidocaine

duration of action is approximately one hour

primarily metabolized in the plasma

INDICATIONS Procaine

used to produce local and regional anesthesia for surgical and diagnostic procedures

DOSE AND ROUTES Procaine

Infiltration: 0.25%, 0.5%

Nerve block: 1.0%, 2.0%

Maximum dose 11 mg/kg or 13 mg/kg with Epinephrine

Toxic IV dose: 450 mg

ADVERSE REACTIONS, PRECAUTIONS, AND INTERACTIONS Procaine

Contraindicated in patients with a known hyper-sensitivity to PABA ester type anesthetics

All local anesthetics can cause CNS stimulation, depression or both


Continue to the PowerPoint Lecture...

From

SFC Hill

Joint Special Operations Medical Training Center In Operational Medicine 2001

Bureau of Medicine and Surgery

Department of the Navy

 

 

 

 

 

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