NBCRNA Regional Anesthesia

Question 1

In spinal anesthesia, which factor most influences the spread of local anesthetic in the intrathecal space?

Accepted Answer

Baricity of the local anesthetic solution relative to CSF

Answer

Total dose of local anesthetic injected

Answer

Patient's height

Answer

Speed of injection

Question 2

The classic presentation of a 'high spinal' or 'total spinal' includes which combination of findings?

Accepted Answer

Severe hypotension, bradycardia, and respiratory arrest

Answer

Hypotension with preserved respiratory function

Answer

Unilateral motor block with ipsilateral sensory loss

Answer

Nausea with normal hemodynamics

Question 3

During epidural anesthesia, a test dose of 3 mL of 1.5% lidocaine with 1:200,000 epinephrine is used to detect what?

Accepted Answer

Intravascular catheter placement (tachycardia) and intrathecal placement (rapid spinal block)

Answer

Subdural catheter migration

Answer

Allergic sensitivity to the local anesthetic

Answer

Adequate epidural space identification

Question 4

Interscalene brachial plexus block provides the best anesthesia for surgery on which area?

Accepted Answer

Shoulder and proximal humerus

Answer

Hand and digits

Answer

Forearm and elbow only

Answer

Axilla and chest wall

Question 5

What is the most serious complication specific to interscalene brachial plexus block?

Accepted Answer

Ipsilateral phrenic nerve palsy causing hemidiaphragm paralysis

Answer

Ulnar nerve sparing requiring supplemental block

Answer

Horner syndrome

Answer

Postoperative shoulder pain rebound

Question 6

Saddle block is a form of spinal anesthesia providing perineal anesthesia; it is achieved by using which technique?

Accepted Answer

Hyperbaric solution injected with patient sitting upright for 5–10 minutes

Answer

Isobaric solution with patient in lithotomy position

Answer

Continuous spinal with catheter at L5–S1

Answer

Bilateral pudendal nerve blocks