meds; CSE labor analgesia Flashcards
Bupivacaine epidural dose
0.0625-0.125%
Bupivacaine spinal dose
1.25-2.5 ml
Ropivacaine epidural dose
0.08-0.2 %
Ropivacaine spinal dose
2.5 - 4.5 ml
Lidocaine with Epid dose for epidural
2% in 5 ml bolus
Fentanyl epidural dose
50-100 mcg
Fentanyl spinal dose
10-25 mcg
Sufentanil epidural dose
5-10 mcg
sufent spinal dose
1.5-5 mcg
morphine spinal dose
0.1-0.2 mg
walking epidural
Ropivacaine = least motor blockade
greatest motor function depression in epidural
lidocaine
lidocaine side effect
vasodilation
detrimental to fetus
Consider local anesthetic toxicity
morphine characteristic in blocks
hydrophilic = slower cephalad spread w/ blocks as compared to fent and sufent that are lipophilic
s/s of LAST
analgesia
lightheadedness
tinnitis
tongue/ circumoral numbness/ tingling/ funny taste
sz
unconsciousness
respiratory arrest
cv arrest
treatment for LAST
CPR
bolus 1.5 ml/kg of 20% lipids over 1 min
gtt of 0.25 ml/kg/ min
repeat bolus q 3-5 min up to 3ml/kg total dose until circulation is restored
increase infusion to 0.5 ml/kg/min if bp declines
max total dose = 8 ml/kg
intralipids MOA
creates lipid compartment; provides fat for myocardial metabolism (micelles)
highly lipid-soluble drugs/ increase lipid solubility will bind
and can cross barrier because nonionized
