Neuraxial Lecture 3 (Exam 1) Flashcards
(26 cards)
Isobaric solution has a baracity of:
1 (Same as CSF)
The density of a LA solution compared to the CSF
Baracity
Hyperbaric solution has a baracity of:
> 1 - sinks and moves downward from the point of injection
Hypobaric solution has a baracity of :
< 1 - moves upwards and rises from the point of injection
Isobaric Bupivicaine dose
0.5% or 0.75% in saline
Isobaric Lidocaine dose
2% in saline
Isobaric Tetracaine dose
0.5% in saline
Hypobaric bupivicaine dose
0.3% in water
Hypobaric Lidocaine dose
0.5% in water
Hypobaric tetracaine dose
0.2% in water
Hyperbaric bupivicaine dose
0.75% in 8.25% dextrose
Hyperbaric lidocaine dose
5% in 7.5% dextrose
Hyperbaric tetracaine dose
0.5% in 5% dextrose
Hyperbaric procaine dose
10% in water
What is the lowest possible level the hyperbaric LA will travel during SAB procedure? (injected at around L4-5)
T6-S2
The spinal cord uptake of the LA is possible due to the _______ nature of the LA
lipid-soluble
Spread of LA occurs in a ______ and _____ direction from the site of injection simultaneously
cephalad and caudad
Does metabolism of the LA take place in the CSF?
NO
How are LA eliminated?
LA are eliminated via reuptake (vessels in the pia mater)
______ drugs have slow reuptake because they have a hihg affinity for epidural fat
Lipophilic (Bupivicaine has a longer duration than lidocaine)
During which procedure are you always aspirate before injection?
Epidural
Epidurals have an onset time of about:
10-25 minutes
When dosing epidurals, we should dose _______ with ___ mL to avoid: (3)
Dose intermittently with 5 mL to avoid:
Accidental High spinal
Hypotension from rapid autonomic blockade
LAST
Re-dose epidurals when you have dropped sensory blockade to ___ segments below baseline block
2 segments below
(If original block was at T4, and now its only at T6, you can re-dose)
