- Joined
- Feb 26, 1999
- Messages
- 1,768
- Reaction score
- 4
OK...I tried to get this started way back yonder - when I had freaking free time as a CA-2. To compliment/complement (I can't freaking spell for $hit), JPP & company's clinical scenario threads, I want to throw out a series of more simplistic, yet potentially controversial clinical questions that seem steeped in mythology & pseudoscience.
How do you dose your Bupivicaine spinals for C/S?
Background: At Dartmouth, the 'range' of answers varied from the middling mythological approach of starting at "1.5ml of 0.775% bupiv for the 'standard' 5'5" lady & adding x-amount for each inch in excess of 5'5". Of course, the "...x-amt added per y-number of inches in excess..." varied by attending. The extremes were: "they all get 1.5ml of 0.75% bupiv" contrasting with "they all get the full 2ml of 0.75% bupiv" on the other end. Being a teaching facility for both anesthesia & OB/Gyn, you can imagine the c/s times were protracted vs. what you expect in the private world...please God, I hope they were protracted & NOT representative of the surgical times I expect to see in the 'real world'!
So, all of you attending-level gurus (and of course, everyone from the lowly CA-1s through the elite (wishful thinking) CA-3s) please chime in with your collective wisdom & techniques. I am all ears...and looking forward to the discussion of real-worled experience, the evidence & alternate way to skin the proverbial cat.
How do you dose your Bupivicaine spinals for C/S?
Background: At Dartmouth, the 'range' of answers varied from the middling mythological approach of starting at "1.5ml of 0.775% bupiv for the 'standard' 5'5" lady & adding x-amount for each inch in excess of 5'5". Of course, the "...x-amt added per y-number of inches in excess..." varied by attending. The extremes were: "they all get 1.5ml of 0.75% bupiv" contrasting with "they all get the full 2ml of 0.75% bupiv" on the other end. Being a teaching facility for both anesthesia & OB/Gyn, you can imagine the c/s times were protracted vs. what you expect in the private world...please God, I hope they were protracted & NOT representative of the surgical times I expect to see in the 'real world'!
So, all of you attending-level gurus (and of course, everyone from the lowly CA-1s through the elite (wishful thinking) CA-3s) please chime in with your collective wisdom & techniques. I am all ears...and looking forward to the discussion of real-worled experience, the evidence & alternate way to skin the proverbial cat.