Certified Post Anesthesia Nurse (CPAN) Practice Exam

What is indicated when a patient’s affected arm becomes warm and flushed during a block for reflex sympathetic dystrophy?

1. Ineffective regional block

2. Severe allergic reaction

3. Successful therapeutic block

4. Extravasation of the medication

The correct answer is: Successful therapeutic block

When a patient's affected arm becomes warm and flushed during a block for reflex sympathetic dystrophy, this indicates a successful therapeutic block. In the context of regional anesthesia, a successful block is often characterized by the resolution of pain and the onset of increased blood flow to the area. The warmth and flushing in the affected arm are signs that the regional anesthetic has effectively interrupted sympathetic nervous system activity, leading to vasodilation and increased blood perfusion. This response is particularly significant in the case of reflex sympathetic dystrophy, where the goal of the block is to alleviate pain and restore normal function to the affected limb. The warmth and flush indicate that the desired pharmacological effect is occurring, which supports the conclusion that the block was effective. Other possible reactions, such as an ineffective regional block, an allergic reaction, or medication extravasation, would typically present with different clinical signs. For example, an ineffective block may result in persistent pain or sensory changes, while a severe allergic reaction would usually involve symptoms such as hives, difficulty breathing, or swelling. Extravasation would likely cause localized swelling, redness, and pain at the injection site rather than systemic warmth and flushing.