Thu18November0755PM 4

Bupivacaine toxicity is a potentially serious complication of local anaesthesia.

Which of the following local anaesthetic techniques using bupivacaine is most likely to lead to drug toxicity?

(Please select 1 option)

Intercostal nerve block This is the correct answer

Thoracic extradural block

Brachial plexus block

Femoral nerve block Incorrect answer selected

Sacral extradural (caudal) block

Explanation

The likelihood of local anaesthetic toxicity is dependent on a number of factors. These include:

Site of injection, i.e. vascularity and presence of fat

Drug dose and concentration

Use of vasoconstrictors, and

Changes in protein binding in relation to intracellular pH.

The most vascular areas into which local anaesthesia is more prone to systemic absorption (in order) are:

Intercostal and paracervical block

Caudal block

Lumbar and thoracic epidural block

Brachial plexus block

Sciatic/femoral nerve block

Subcutaneous infiltration.

Answer Statistics

1

57%

2

17%

3

12%

4

9%

5

6%

Times answered: 265