Suggested Level of Knowlege: Detailed

LOs

BT_RA 1.3 Discuss the pharmacology of local anaesthetic agents including:

· Mechanisms of action

· Comparative pharmacology of different agents

· Toxicity

· Use of adjuvant agents to enhance the quality or extend duration of block

· Pharmacokinetics of drugs administered in the epidural and subarachnoid space

Past SAQs

2015.1, 2008.1 A surgeon wishes to use topical local anaesthetic in the nose before surgery in a 30 year old 70 kg man. He normally uses topical cocaine 5% plus lignocaine 2% with adrenaline 1:100,000 injection. What volumes of these drugs can be used safely? What are the potential toxic effects of cocaine and how does lignocaine and adrenaline affect these?

2014.2 20mls of 0.5% bupivacaine is inadvertently administered intravenously over 15 seconds to a 60 year old, 60kg woman. Describe the potential complications and mechanisms of these.

2012.2 Classify the toxic effects of local anaesthetic drugs. Detail the potential for, and mechanisms of, toxicity of prilocaine.

2011.1, 2009.1, 2007.2 Describe the factors which increase the risk of systemic toxicity with amide local anaesthetic  agents.

2002.1, 1999.2 Outline the toxicity of local anaesthetics.

Local Anaesthetic Toxicity