ABA ABA Regional Anesthesia and Pain Management 1 — Questions and Answers
Question 1: Which nerve roots are primarily targeted in an interscalene brachial plexus block for shoulder surgery?
- Musculocutaneous nerve only
- C5-C6 nerve roots (Correct answer)
- Ulnar nerve
- Median nerve
Correct answer: C5-C6 nerve roots
The interscalene block targets C5-C6 nerve roots of the brachial plexus, providing excellent analgesia for shoulder procedures.
Question 2: What is the maximum recommended dose of plain bupivacaine for peripheral nerve blocks?
- 1 mg/kg
- 2 mg/kg (Correct answer)
- 3 mg/kg
- 4 mg/kg
Correct answer: 2 mg/kg
The maximum safe dose of bupivacaine is 2 mg/kg (up to 150 mg) to avoid systemic toxicity.
Question 3: Which complication is most specifically associated with interscalene brachial plexus blocks?
- Pneumothorax (Correct answer)
- Hemothorax
- Epidural spread
- Femoral nerve palsy
Correct answer: Pneumothorax
Pneumothorax is a known complication of interscalene blocks due to the proximity of the lung apex to the injection site.
Question 4: What is the first-line pharmacologic treatment for local anesthetic systemic toxicity (LAST)?
- Epinephrine 1 mg IV
- 20% lipid emulsion IV (Correct answer)
- Sodium bicarbonate IV
- Propofol IV
Correct answer: 20% lipid emulsion IV
20% lipid emulsion is the first-line treatment for LAST as it sequesters the lipid-soluble local anesthetic from cardiac tissue.
Question 5: Which regional technique is preferred for analgesia after total knee arthroplasty because it preserves quadriceps strength?
- Femoral nerve block
- Adductor canal block (Correct answer)
- Sciatic nerve block
- Lumbar plexus block
Correct answer: Adductor canal block
The adductor canal block provides knee analgesia while preserving quadriceps motor strength, allowing earlier ambulation after TKA.
Question 6: What does the standard epidural test dose typically contain to detect intravascular catheter placement?
- 3 mL of 1.5% lidocaine with 1:200,000 epinephrine (Correct answer)
- 5 mL of 0.5% bupivacaine
- 2 mL of 2% lidocaine plain
- 10 mL of normal saline
Correct answer: 3 mL of 1.5% lidocaine with 1:200,000 epinephrine
The standard epidural test dose is 3 mL of 1.5% lidocaine with epinephrine to detect intravascular or intrathecal catheter placement.
ABA ABA Regional Anesthesia and Pain Management 1
Which nerve roots are primarily targeted in an interscalene brachial plexus block for shoulder surgery?