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Regional Anesthesia In Otolaryngology

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References Atlas of Regional Anesthesia, Katz et. al, Multiple pages, Appleton and Lange 1994 Techniques of Regional Anaesthesia, Scott et. al, ... – PowerPoint PPT presentation

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Title: Regional Anesthesia In Otolaryngology


1
Regional Anesthesia In Otolaryngology
  • University of Texas Medical Branch
  • Dept. of Otolaryngology
  • Jacques Peltier MD
  • Francis Quinn MD
  • May 24, 2006

2
Advantages of Local Anesthesia
  • The patient is conscious during surgery.
  • Smooth postoperative course.
  • Patient awake and maintains his own airway.
  • Less pain needs less narcotics, lighter
    anesthesia in general cases.
  • Less nursing care after procedures, less
    admissions.
  • Less expensive

3
Disadvantages of Local Anesthesia
  • The patient may prefer to be asleep
  • Specialized skill necessary.
  • Some blocks require up to 30 minutes to be fully
    effective.
  • Analgesia may not always be totally effective,
    and general anesthesia may be required anyway.

4
Disadvantages of Local Anesthesia
  • Generalized toxicity may occur if local
    anesthetic drugs are given intravenously by
    mistake or an overdose is given.
  • Widespread sympathetic blockade can result in
    hypotension.
  • There is a small but definite incidence of
    prolonged nerve damage.

5
Local Anesthetics
  • Agent Dose Onset/Duration
  • Lidocaine with epi (1 or 2) 7mg/kg Fast/medium
  • Lidocaine without epi 4.5mg/kg Fast/short
  • Mepivacaine without epi (3) 5.5mg/kg Fast/short
  • Bupivacaine with epi (0.5) 1.3mg/kg Long/long
  • Articaine with epi (4.0) 7mg/kg Fast/medium
  • ADULT DOSES IN PATIENTS WITHOUT CARDIAC HISTORY

6
Scalp Blocks
7
Scalp Blocks
8
Scalp Blocks
9
Scalp Blocks
10
Scalp Blocks
11
Trigeminal Nerve Blocks
12
Gasserian Ganglion Block
13
Mandibular Nerve Blocks
14
Mandibular Nerve Blocks
15
Mandibular Nerve Blocks
16
Mandibular Nerve Blocks
17
Mandibular Nerve Blocks
18
Mandibular Nerve Blocks
19
Mandibular Nerve Blocks
20
Mandibular Nerve Blocks
21
Mandibular Nerve Blocks
22
Mandibular Nerve Blocks
23
Mandibular Nerve Blocks
24
Inferior Alveolar Nerve Block
25
Inferior Alveolar Nerve Block
26
Inferior Alveolar Nerve Block
27
Inferior Alveolar Nerve Block
28
Inferior Alveolar Nerve Block
29
Inferior Alveolar Nerve Block
30
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31
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32
Mental Nerve Block
33
Mental Nerve Block
34
Mental Nerve Block
35
Maxillary Nerve Blocks
36
Maxillary Nerve Blocks
37
Maxillary Nerve Blocks
38
Maxillary Nerve Blocks
39
Maxillary Nerve Blocks
40
Maxillary Nerve Blocks
41
Local Blocks
42
Supraorbital Nerve Blocks
43
Supratrochlear Nerve Blocks
44
Infraorbital Nerve Blocks
45
Nasociliary and Anterior Ethmoidal Nerve Blocks
46
Local Blocks for Nasal Surgery
47
Maxillary Nerve Blocks
48
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49
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50
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51
Local Blocks for Nasal Surgery
52
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53
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54
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55
Local Ear Blocks
56
Local Ear Blocks
57
Local Ear Blocks
58
Local Ear Blocks
59
Local Ear Blocks
60
Cervical Blocks
61
Cervical Blocks
62
Cervical Blocks
63
Cervical Blocks
64
Cervical Blocks
65
Cervical Blocks
66
Cervical Blocks
67
Spinal Accessory Nerve Block
68
Glossopharyngeal Nerve Block
69
Glossopharyngeal Nerve Block
70
Glossopharyngeal Nerve Block
71
Glossopharyngeal Nerve Block
72
Airway and Laryngeal Blocks
73
Laryngeal Anesthesia
74
Laryngeal Anesthesia
75
Laryngeal Anesthesia
76
Laryngeal Anesthesia
77
Laryngeal Anesthesia
78
Laryngeal Anesthesia
79
Laryngeal Anesthesia
80
Laryngeal Anesthesia
81
Laryngeal Anesthesia
82
Laryngeal Anesthesia
83
Laryngeal Anesthesia
84
Special thanks to Melinda Quinn for help in
scanning slides used in this presentation.
85
References
  • Atlas of Regional Anesthesia, Katz et. al,
    Multiple pages, Appleton and Lange 1994
  • Techniques of Regional Anaesthesia, Scott et. al,
    Appleton and Lange, 1989
  • Regional Anesthesia of the oral cavity, Jastak
    and yagiela, The Mosby Company 1981
  • Illustrated Handbook in Local Anaesthesia,
    Eriksson, W.B. Saunders Company 1979
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