meds; CSE labor analgesia

Question 1

Bupivacaine epidural dose

Answer 1

0.0625-0.125%

Question 1

Bupivacaine spinal dose

Answer 1

1.25-2.5 ml

Question 2

Ropivacaine epidural dose

Answer 2

0.08-0.2 %

Question 3

Ropivacaine spinal dose

Answer 3

2.5 - 4.5 ml

Question 4

Lidocaine with Epid dose for epidural

Answer 4

2% in 5 ml bolus

Question 5

Fentanyl epidural dose

Answer 5

50-100 mcg

Question 6

Fentanyl spinal dose

Answer 6

10-25 mcg

Question 7

Sufentanil epidural dose

Answer 7

5-10 mcg

Question 8

sufent spinal dose

Answer 8

1.5-5 mcg

Question 9

morphine spinal dose

Answer 9

0.1-0.2 mg

Question 10

walking epidural

Answer 10

Ropivacaine = least motor blockade

Question 11

greatest motor function depression in epidural

Answer 11

lidocaine

Question 12

lidocaine side effect

Answer 12

vasodilation
detrimental to fetus

Consider local anesthetic toxicity

Question 13

morphine characteristic in blocks

Answer 13

hydrophilic = slower cephalad spread w/ blocks as compared to fent and sufent that are lipophilic

Question 14

s/s of LAST

Answer 14

analgesia
lightheadedness
tinnitis
tongue/ circumoral numbness/ tingling/ funny taste
sz
unconsciousness
respiratory arrest
cv arrest

Question 15

treatment for LAST

Answer 15

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

Question 16

intralipids MOA

Answer 16

creates lipid compartment; provides fat for myocardial metabolism (micelles)

highly lipid-soluble drugs/ increase lipid solubility will bind
and can cross barrier because nonionized