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Chapter 58. Regional Anesthesia and Acute Pain Management in the Emergency Department
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Which nerve needs to be blocked to produce an excellent anesthesia and analgesia to remove foreign bodies from the sole of the foot?
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B. Superficial peroneal nerve
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A is correct. Tibial nerve needs to be blocked to produce an excellent anesthesia and analgesia to remove foreign bodies from the sole of the foot.
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B is incorrect. The dorsum of the foot is innervated by the superficial peroneal nerve.
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C is incorrect. The webspace between first and second toes is innervated by the deep peroneal nerve.
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D is incorrect. The saphenous nerve innervates the medial malleolus and a variable portion of the medial side of the leg below the knee.
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Which of the following statements is true regarding ketamine?
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A. Ketamine has a unique dissociative anesthetic effect at low doses (0.1–0.3 mg/kg IV).
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B. Ketamine is an NMDA receptor agonist.
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C. Ketamine is a potent analgesic at low doses (0.1–0.3 mg/kg IV).
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D. S-ketamine is not suitable for use in the ED due to substantially increased risk of psychotropic side effects.
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C is correct. Ketamine is a potent analgesic at low doses (0.1–0.3 mg/kg IV).
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A is incorrect. Ketamine is an NMDA receptor antagonist with a unique dissociative anesthetic effect at higher doses (1–2 mg/kg IV).
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B is incorrect. Ketamine is an NMDA receptor antagonist.
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D is incorrect. While not available in the USA, S-ketamine is uniquely suitable for use in the ED due to substantially reduced psychotropic side effects.
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Which of the following agents is suitable for emergency topical anesthesia in nonintact skin?
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A. Eutectic 1:1 mixture of 2.5% lidocaine and 2.5% prilocaine (EMLA)
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B. 4% lidocaine cream in a liposomal matrix (LMX)
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D. Lidocaine 4%, epinephrine 0.1%, and tetracaine 0.5% (LET)
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D is correct. Lidocaine 4%, epinephrine 0.1%, and tetracaine 0.5% (LET), is suitable for emergency topical anesthesia in non-intact skin.
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A, B, and C are incorrect. These agents are suitable for emergency topical anesthesia in the intact skin. See Table 58–1.
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