The thematic module 3. A general anesthesiology and intensive therapy Practical employment # 11

Theme: local anesthesia

I. Actuality of theme.

Local anesthesia has great significance in surgical practice. Through this type of anesthesia it is possible to implement not only simple operations but also more difficult cavernous operative interferences. Due to this, it is essential to master this skill of implementation and execution. For students in the 3^rd year of study, the acquired knowledge and skills on the given theme will be necessary in the study of surgery and in senior courses. Professional surgical activity is impossible without the use of local anesthesia.

II. Purpose of the lesson:

1. To familiarize with the value of local anesthesia during surgical operations and bandaging of patients (=1).

2. To know about sensations and the state of the patient during conduction of local anesthesia (=1).

3. To define and differentiate local from general anesthesia (=2).

4. To know the types of local anesthesia (=2).

5. To know medicines (drugs) which are used for local anesthesia (=2).

6. To know indications and contraindications for local anesthesia, and also advantages over other methods of anaesthetizing (=2).

7. To learn the technique of conduction of infiltration anesthesia (=3).

8. To learn the method of conducting of exploratory anesthesia by Oberst-Lukashevich (=3).

III. Providing of initial level of knowledge-abilities

Literature:

1. Butursky A. “General surgery”. (Simferopol 2004)

2. S. I. Shevchenko; A. A. Tolkoglas and etc. “Surgery” (Kharkov 2004)

3. Methodological Instruction.

Tests and tasks for verification of initial level of knowledge

1. In which diseases is local anesthesia used according to Lukashevich-Oberst method?

1. nephritis

2. ingrown toe-nail +

3. paraproktitis

4. pancreonecrosis

5. panaris +

6. asphyxia

2. What solutions can be used for local anesthesia?

1. Furagine

2. Dikaine+

3. Ftorotan

4. Gemodez

5. Novocain+

6. Poliglyukin

3. How does pain influence basic exchange

1. the selection of adrenalin is multiplied +

2. the selection in the blood of thyroxin diminishes

3. the selection of histamine diminishes

4. the selection of serotonin diminishes

5. the selection prostaglandin is multiplied +

6. the selection of quinine diminishes

4. What solution of Novocain is used in intraosteal anesthesia?

1. 0,5 %+

2. 2%

3. 3%

4. 1%

5. 0,25%+

6. 5%

5. Indications for retro-mammary gland anesthesia?

1. phlegmonic phase of mastitis

2. infiltration phase of mastitis+

3. gangrenous phase of mastitis

4. behind mammary gland abscess

5. serous phase of mastitis +

6. underareolaris abscess

6. What is Vishnevsky blockade used for?

1. for the prophylaxis of reflex asphyxia

2. for the removal of paresis of intestine

3. for the medical treatment pleuro-pulmonary shock +

4. for the prophylaxis of tetanilla of ventricles of heart

5. for the prophylaxis plevro pleuropulmonary shock +

6. for abatement of musculature and prophylaxis of paraplegia

7. How soon does anesthesia appear after a peridural anesthesia?

a. 5 minutes

b. 10 minutes

c. 15 minutes

d. 20 minutes

e. 25 minutes +

f. 30 minutes +

8. In which type of local anesthesia is it necessary to initially use a tourniquet?

1. anesthesia by cooling

2. intravascular anesthesia +

3. peridural anesthesia

4. intraosteal anesthesia +

5. combined anesthesia

6. spinal anesthesia

9. To reposition a break of the lower third of the radial bone, what anesthesia is used?

1. infiltration anesthesia

2. case blockade

3. anesthesia by greasing

4. introduction of a 2% Novocaine to the haematoma in the place of fracture +

5. peridural anesthesia

6. blockade by Kulen-Kampf +

10. What complication(s) can be meet with the use of paranephron Novocain blockade?

1. necrosis of fabrics

2. allergic reaction

3. injury of kidney +

4. vomiting

5. overdose

6. injury of ureter +

11. Signs of poisoning of local anesthetics.

1. dyspnea +

2. violation of cerebral circulation of blood

3. bradicardia

4. anurea

5. dilation of pupils

6. dizziness +

12. Which of the following methods of local anesthesia are exploratory?

1. anesthesia by cooling

2. anesthesia by smearing (topical)

3. peridural anesthesia +

4. intra-arterial anesthesia

5. spinal anesthesia +

6. intraosteal anesthesia

13. What complication(s) can arise with the use of Novocain?

1. over dose

2. anaphylactic shock +

3. accidental introduction into the artery

4. nettle-rash +

5. accidental introduction into the vein

6. chemical irritation of tissue-necrosis

14. What solutions of Novocain can be used for a paranephral blockade?

1. 1%

2. 5%

3. 10%

4. 2%

5. 0,25% +

6. 0,5% +

15. What medications are used in case of poisoning by anesthetic drugs?

1. Antibiotics

2. cordials +

3. protease enzymes

4. dimedrol +

5. Anticoagulants

6. muscular relaxation drugs