B. Local Anesthesia [13]^
These agents reversibly block the conduction of neural impulses
along central and peripheral nerve pathways. Their use produce
analgesia with minimal physiologic changes, therefore making them
desirable for children undergoing procedures and post traumatic pain
management.
Dosing: maximum local anesthetic dosing guidelines (Table 3)
Absorption from highest to lowest:
intercostal, intrapleural, intratracheal > caudal/epidural > brachial
plexus > distal peripheral > subcutaneous > fat
Precautions:
o systemic toxicity is determined by total dose, protein
binding, absorption into blood and site of injection
o bupivacaine toxicity: occurs with inadvertent injection of
bupivacaine intravenously. It presents as asystole
refractory to treatment causing death. Treatment is IV
intralipid
C. Regional anesthesia [13]^
- Nerve block
Injection of local anesthetic to provide regional anesthetic for
procedure or treat regional pain