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Regional Anesthesia In Otolaryngology

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Regional Anesthesia In Otolaryngology

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

    2. 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. 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. 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. 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. 6 Scalp Blocks

    7. 7 Scalp Blocks

    8. 8 Scalp Blocks

    9. 9 Scalp Blocks

    10. 10 Scalp Blocks

    11. 11 Trigeminal Nerve Blocks

    12. 12 Gasserian Ganglion Block

    13. 13 Mandibular Nerve Blocks

    14. 14 Mandibular Nerve Blocks

    15. 15 Mandibular Nerve Blocks

    16. 16 Mandibular Nerve Blocks

    17. 17 Mandibular Nerve Blocks

    18. 18 Mandibular Nerve Blocks

    19. 19 Mandibular Nerve Blocks

    20. 20 Mandibular Nerve Blocks

    21. 21 Mandibular Nerve Blocks

    22. 22 Mandibular Nerve Blocks

    23. 23 Mandibular Nerve Blocks

    24. 24 Inferior Alveolar Nerve Block

    25. 25 Inferior Alveolar Nerve Block

    26. 26 Inferior Alveolar Nerve Block

    27. 27 Inferior Alveolar Nerve Block

    28. 28 Inferior Alveolar Nerve Block

    29. 29 Inferior Alveolar Nerve Block

    30. 30

    31. 31

    32. 32 Mental Nerve Block

    33. 33 Mental Nerve Block

    34. 34 Mental Nerve Block

    35. 35 Maxillary Nerve Blocks

    36. 36 Maxillary Nerve Blocks

    37. 37 Maxillary Nerve Blocks

    38. 38 Maxillary Nerve Blocks

    39. 39 Maxillary Nerve Blocks

    40. 40 Maxillary Nerve Blocks

    41. 41 Local Blocks

    42. 42 Supraorbital Nerve Blocks

    43. 43 Supratrochlear Nerve Blocks

    44. 44 Infraorbital Nerve Blocks

    45. 45 Nasociliary and Anterior Ethmoidal Nerve Blocks

    46. 46 Local Blocks for Nasal Surgery

    47. 47 Maxillary Nerve Blocks

    48. 48

    49. 49

    50. 50

    51. 51 Local Blocks for Nasal Surgery

    52. 52

    53. 53

    54. 54

    55. 55 Local Ear Blocks

    56. 56 Local Ear Blocks

    57. 57 Local Ear Blocks

    58. 58 Local Ear Blocks

    59. 59 Local Ear Blocks

    60. 60 Cervical Blocks

    61. 61 Cervical Blocks

    62. 62 Cervical Blocks

    63. 63 Cervical Blocks

    64. 64 Cervical Blocks

    65. 65 Cervical Blocks

    66. 66 Cervical Blocks

    67. 67 Spinal Accessory Nerve Block

    68. 68 Glossopharyngeal Nerve Block

    69. 69 Glossopharyngeal Nerve Block

    70. 70 Glossopharyngeal Nerve Block

    71. 71 Glossopharyngeal Nerve Block

    72. 72 Airway and Laryngeal Blocks

    73. 73 Laryngeal Anesthesia

    74. 74 Laryngeal Anesthesia

    75. 75 Laryngeal Anesthesia

    76. 76 Laryngeal Anesthesia

    77. 77 Laryngeal Anesthesia

    78. 78 Laryngeal Anesthesia

    79. 79 Laryngeal Anesthesia

    80. 80 Laryngeal Anesthesia

    81. 81 Laryngeal Anesthesia

    82. 82 Laryngeal Anesthesia

    83. 83 Laryngeal Anesthesia

    84. 84 Special thanks to Melinda Quinn for help in scanning slides used in this presentation.

    85. 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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