Lidocaine 0.5% with epi effective for skin local?

[pastafan]

With the lidocaine shortage I am looking for alternatives. I have only used Lido 0.5% for Bier blocks. Will this concentration be effective for skin local?

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[deleted162650]

With the lidocaine shortage I am looking for alternatives. I have only used Lido 0.5% for Bier blocks. Will this concentration be effective for skin local?

Yes, it’ll work just fine. If you’re just talking about skin local for a needle stick, then pretty much anything works. There’s a study out there showing saline is just as effective as lido for skin local during epidural placement.

 

[Twiggidy]

Yes, it’ll work just fine. If you’re just talking about skin local for a needle stick, then pretty much anything works. There’s a study out there showing saline is just as effective as lido for skin local during epidural placement.

Wow. That's hilarious

 

[deleted162650]

Wow. That's hilarious

I use the 1/8th% bupi + fent bag solution for skin local for all my epidurals, and I’ll vouch that it works just as good as 2% lido. Hell, it probably even burns less.

 

[Twiggidy]

I use the 1/8th% bupi + fent bag solution for skin local for all my epidurals, and I’ll vouch that it works just as good as 2% lido. Hell, it probably even burns less.

That's actually good to know. Most of the complaints I tend to hear during epidurals/spinals is during local infiltration

 

[parcus]

Most of the spinals we did had no local. 50 mcg of IV fent +2 mg of midaz and patient wouldnt feel or remember a thing, even if it required multiple attempts. Always did local for the epi though.

 

[dhb]

There’s a study out there showing saline is just as effective as lido for skin local during epidural placement.

Yep do a skin weal with 0.9% saline and fire away. I've seen it done for a pleural drain.

 

[dchz]

There’s a study out there showing saline is just as effective as lido for skin local during epidural placement.

Yep do a skin weal with 0.9% saline and fire away. I've seen it done for a pleural drain.

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was Screaming the whole time...

SCREAMING*

 

[Twiggidy]

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was creaming the whole time...

Salty just trying to get me fired so I have to come down to SoCal with him lol

 

[deleted162650]

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was creaming the whole time...

Not trolling. The study has been done. You prob just happened to do it on a wimpy pt that woulda “creamed” either way.

 

[deleted162650]

Salty just trying to get me fired so I have to come down to SoCal with him lol

We are gonna need another cardiac guy sooner than later.

 

[pgg]

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was creaming the whole time...

No, it's a real effect.

Works better as a skin wheal rather than infiltration of a larger area, if that makes sense.

 

[Gern Blansten]

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was creaming the whole time...

Weird response from the patient. You should definitely write that up as a case report.

 

[pastafan]

Never believed in a skin wheal, except for IV start, they hurt. Less painful to bury needle and inject on the way out.

 

[dhb]

I would think it works by nerve stunning by compression or deplacement, you have to go strait in after the saline skin weal.

 

[Hoya11]

You guys are trolling right? Once I accidentally used the saline bottle rather than the 2% lido in the kit and the patient was creaming the whole time...

you should have showed him the study ...