Local Anesthetic Dosing- Spinals

Question 1

Treatment for LA Toxicity

Answer 1

20% Intralipid (lipid emulsion)

rapid bolus immediately 1.5 mL/kg

follow with infusion . 0.25 mL/kg/min x 10 minutes

Question 2

Exparel Liposome

Answer 2

Bupivacaine extended release liposome injection

• Do not mix with other LAs at same site
• Do not mix with shorter acting LA bc will expedite breakdown and cause subsequent bupivacaine toxicity
• Extends up to 96 hrs
• dose depends on surgical site
• MAX= 266 mg or 20 mL

Question 3

Prilocaine

Answer 3

10%
1-2 mL
100-200 mg total dose
hyperbaric
5% glucose
30-60 minutes DOA

Question 4

Lidocaine

Answer 4

1.5, 5%
1-2 mL
30-100 mg total dose
hyperbaric
7.5% glucose
30-90 minutes DOA

Question 5

Mepivicaine

Answer 5

4%
1-2 mL
40-80 mg total dose
hyperbaric
9% glucose
30-90 minutes DOA

Question 6

Tetracaine

Answer 6

0. 25-1% in 1-4 mL, 5-20 mg, hyperbaric, 5% glucose, 90-200 mins
1. 25% in 2-6 mL, 5-20 mg, hypobaric, 90-200 mins

1% in 1-2 mL, 5-20 mg, isobaric, 90-200 mins

Question 7

Dibucaine

Answer 7

0. 25% in 1-2 mL, 2.5-5.0 mg, hyperbaric, 5% glucose, 90-200 mins
1. 5% in 1-2 mL, 5-10 mg, isobaric, 90-200 mins
2. 06% in 5-20 mL, 3-12 mg, hypobaric, 90-200 mins

Question 8

Bupivacain
Levobupivacaine
Ropivacaine

Answer 8

0. 50% 3-4 mL, 15-20 mg, 90-200 min

0. 75%2-3 mL, 15-20 mg, 90-200 min