FLS Module 2 Questions with 100% Pass
/Indications for using local anesthesia in laparoscopy - Answer-no conclusive evidence
that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic
laparoscopies or hernia repairs
/.Types of local anesthesia - Answer-Bupivacaine, Ropivacaine, Lidocaine
/.Advantages of epidural anesthesia - Answer-Decreased post-operative anesthesia and
decreased length of post-op ileus as well as improved muscle relaxation.
/.What medication can you give to prevent bradyarrhythmias in lap surgery? - Answer-
Prophylactic atropine prevents bradyarrhythmias caused by pneumoperitoneum but
causes excessive dry mouth so better to give intra-op rather than pre-op. Can give
glycopyrrolate
/.What class of meds are used pre-op for relaxation of patients - Answer-Benzos. For
relaxation and also to give amnesia.
/.What meds should patient take prior to surgery? - Answer-H2 blocker or non-
particulate antacid sodium citrate to minimize effects of aspiration should it occur. Also
any chronic cardiovascular or pulmonary medications
/.What components are important for anesthetizing a patient for laparoscopy - Answer-
IV induction + GETA and neuromuscular blockade
/.Can you use an LMA for laparoscopy? - Answer-controversial
/.Does the use of nitrous oxide as an insufflating gas cause bowel distension - Answer-
usually not seen (rare) unless patient has a bowel obstruction
/.Common patient positions in surgery - Answer-Supine, Trendelenburg, Reverse T-
burg, Lithotomy, lateral decubitus
/.How should you position the arms in a pelvic laparoscopic surgery - Answer-Arm
tucked to the sides. Ensure hands are not near a break in the table to avoid a hand
injury if table is flexed during surgery
/.How should you position the arms in an upper abdominal surgery - Answer-Arms
abducted to 90 degree angle but not greater than 90 to avoid brachial plexus stretch
injury
, /.What are some key elements to keeping patient safe in a steep reverse Trendelenburg
position - Answer-Foot board to keep patient from sliding, safety belt to keep patients
knees from buckling
/.Keys to safely positioning a patient in lithotomy position - Answer-Fit the equipment to
the patient, not the patient to the equipment. Allen stirups preferable to candy cane
stirrups given more movements.
/.In an omentectomy, what level should the knees be placed in the lithotomy position for
optimal positioning? - Answer-For open surgery such as omenectomy it's important to
make sure the knees are level with the torso to keep the instruments from interfering
with the knees
/.Decubitus position precautions - Answer-avoid stretch in brachial plexus, roll in the the
axilla on the dependent side, with a an arm board for the contralateral arm. Can use a
bean bag but it cannot extend too far anterior or posterior to avoid interference with port
placement and manipulation
/.What is the risk to using a vacuum sealed bean bag rather than pillows or blankets for
positioning a patient - Answer-Higher risk of pressure injury with the vacuum sealed bag
as it is more firm than pillows or blankets
/.What position do you need to consider for adrenal surgery? - Answer-Lateral decubitus
with the table flexed to increase the dimension between the costal margin and the iliac
crest. Allows more space for access to the target organ.
/.modified decubitus - Answer-Allows for rotation between supine and lateral decubitus
positioning.
Must adequately secure the patient.
has all of the benefits of lateral decub but able to quickly rotate to supine if needing to
convert to an open procedure midline incision.
Avoids flank or subcostal incision which may be intolerable
/.Surgeries where the modified decubitus position are used - Answer-splenectomy,
nephrectomy, adrenalectomy
/.What procedure can be performed using local anesthesia alone or with mild sedation -
Answer-Diagnostic laparoscopy
/.Important factors for positioning a patient for laparoscopic surgery - Answer-Avoidance
of position related nerve injuries, prevention of DVT, ensuring adequate exposure for
target organ
/.Advantages of general anesthesia - Answer-allows for complete neuromuscular
relaxation, good control of ventilation, more flexibility in patient positioning
/Indications for using local anesthesia in laparoscopy - Answer-no conclusive evidence
that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic
laparoscopies or hernia repairs
/.Types of local anesthesia - Answer-Bupivacaine, Ropivacaine, Lidocaine
/.Advantages of epidural anesthesia - Answer-Decreased post-operative anesthesia and
decreased length of post-op ileus as well as improved muscle relaxation.
/.What medication can you give to prevent bradyarrhythmias in lap surgery? - Answer-
Prophylactic atropine prevents bradyarrhythmias caused by pneumoperitoneum but
causes excessive dry mouth so better to give intra-op rather than pre-op. Can give
glycopyrrolate
/.What class of meds are used pre-op for relaxation of patients - Answer-Benzos. For
relaxation and also to give amnesia.
/.What meds should patient take prior to surgery? - Answer-H2 blocker or non-
particulate antacid sodium citrate to minimize effects of aspiration should it occur. Also
any chronic cardiovascular or pulmonary medications
/.What components are important for anesthetizing a patient for laparoscopy - Answer-
IV induction + GETA and neuromuscular blockade
/.Can you use an LMA for laparoscopy? - Answer-controversial
/.Does the use of nitrous oxide as an insufflating gas cause bowel distension - Answer-
usually not seen (rare) unless patient has a bowel obstruction
/.Common patient positions in surgery - Answer-Supine, Trendelenburg, Reverse T-
burg, Lithotomy, lateral decubitus
/.How should you position the arms in a pelvic laparoscopic surgery - Answer-Arm
tucked to the sides. Ensure hands are not near a break in the table to avoid a hand
injury if table is flexed during surgery
/.How should you position the arms in an upper abdominal surgery - Answer-Arms
abducted to 90 degree angle but not greater than 90 to avoid brachial plexus stretch
injury
, /.What are some key elements to keeping patient safe in a steep reverse Trendelenburg
position - Answer-Foot board to keep patient from sliding, safety belt to keep patients
knees from buckling
/.Keys to safely positioning a patient in lithotomy position - Answer-Fit the equipment to
the patient, not the patient to the equipment. Allen stirups preferable to candy cane
stirrups given more movements.
/.In an omentectomy, what level should the knees be placed in the lithotomy position for
optimal positioning? - Answer-For open surgery such as omenectomy it's important to
make sure the knees are level with the torso to keep the instruments from interfering
with the knees
/.Decubitus position precautions - Answer-avoid stretch in brachial plexus, roll in the the
axilla on the dependent side, with a an arm board for the contralateral arm. Can use a
bean bag but it cannot extend too far anterior or posterior to avoid interference with port
placement and manipulation
/.What is the risk to using a vacuum sealed bean bag rather than pillows or blankets for
positioning a patient - Answer-Higher risk of pressure injury with the vacuum sealed bag
as it is more firm than pillows or blankets
/.What position do you need to consider for adrenal surgery? - Answer-Lateral decubitus
with the table flexed to increase the dimension between the costal margin and the iliac
crest. Allows more space for access to the target organ.
/.modified decubitus - Answer-Allows for rotation between supine and lateral decubitus
positioning.
Must adequately secure the patient.
has all of the benefits of lateral decub but able to quickly rotate to supine if needing to
convert to an open procedure midline incision.
Avoids flank or subcostal incision which may be intolerable
/.Surgeries where the modified decubitus position are used - Answer-splenectomy,
nephrectomy, adrenalectomy
/.What procedure can be performed using local anesthesia alone or with mild sedation -
Answer-Diagnostic laparoscopy
/.Important factors for positioning a patient for laparoscopic surgery - Answer-Avoidance
of position related nerve injuries, prevention of DVT, ensuring adequate exposure for
target organ
/.Advantages of general anesthesia - Answer-allows for complete neuromuscular
relaxation, good control of ventilation, more flexibility in patient positioning
