0.75% bupivacaine?

[Lecithin5]

Never really saw this until recently at a surgical center. Anyone ever use it for surgical anesthetic blocks? Obviously not ideal as compared to ropi, but from a purely onset and dense/efficacious standpoint, how would you rank the following (let's say, for a single shot supraclavicular): 20cc of 0.75% bupi vs. 20 cc of 0.75% ropi vs. a combo of 10cc 0.5% bupi plus 10cc of 2% lido?

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[Skip2myLou]

I've never used 0.75% for anything besides retrobulbars/peribulbars . I guess 10 ml of 0.75% is not terribly high total amount of bupivicaine but I'd rather use 20 ml 0.5% ropi/bupi


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[ZzzPlz]

For time of onset I'd rather mix in some 2% lido rather than higher concentration bupi. We have a busy hand surgeon at our surgery center and I'll do supraclav or axillary blocks when we get in room and are hooking up monitors and the patient is ready for a MAC by the time the drapes go up

 

[Lecithin5]

Thanks. Zzz- that's pretty slick!

 

[deleted162650]

I didn't think 0.75 bupi was still commercially available except for the heavy spinal kit vials. There were a few OB deaths from epidural use of 0.75%. Even though total dose may be the same, a little squirt intravascular with the super concentrated stuff = .

 

[Lecithin5]

I didn't think 0.75 bupi was still commercially available except for the heavy spinal kit vials. There were a few OB deaths from epidural use of 0.75%. Even though total dose may be the same, a little squirt intravascular with the super concentrated stuff = .

Interestingly, the medical supply company that the asc uses readily sells 20 cc vials of 0.75 bupi, but not ropi of the same concentration. I was surprised by that

 

[Scotty_G]

I don't think you should use .75%. It seems silly....