Ob Infusions

[Dryacku]

What concentrations are you guys using in your epidurals for OB for infusions, not the initial boluses?

Also what do you think is the max you can use?

Just being having issues with getting women either not comfortable enough or then too comfortable and can not push

Thanks

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[rsgillmd]

What concentrations are you guys using in your epidurals for OB for infusions, not the initial boluses?

Also what do you think is the max you can use?

Just being having issues with getting women either not comfortable enough or then too comfortable and can not push

Thanks

We use Bupivacaine 0.1% with Fentanyl 2 mcg/ml at 10 ml/hr and usually set a PCEA dose of 5 ml q15 min prn. Seems to work well. We are conducting a study using varying amounts of basal infusion and bolus doses. However, there is insufficient data so far to conclude anything.

Remember: narcotics work well for stage 1 labor, but what you really need is volume for stage 2 labor. For the ones that are fully dilated and need pain relief before pushing, I give 15 ml of Bupivacaine 0.1%.

I don't think there is any magic recipe. If you do a search you will probably find people posting very different maintenance regimens.

 

[dhb]

Strait ropivacaine 0.125% 10ml/h OB nurses are happy. If insufficient i'll give a little bolus and bump the pump to 11 or 12 ml/h rarely more.

 

[DreamMachine]

.

 

[Breezee]

Ropivacaine 0.1% plus Fentanyl 2mcg/mL at 8-12 mL/hr, demand dose 6-8 mL q 8-10 min.

 

[jetproppilot]

What concentrations are you guys using in your epidurals for OB for infusions, not the initial boluses?

Also what do you think is the max you can use?

Just being having issues with getting women either not comfortable enough or then too comfortable and can not push

Thanks

I've seen and used many infusions.

IMHO DA BEST infusion is....

DRUM ROLL PLEASE

Ropiv .2% with sufentanil haffa mike per mL. Run it at twelve an hour.

That particular infusion is like the George Foreman Grill:

"SET IT AND FORGET IT."

 

[canjosh]

That particular infusion is like the George Foreman Grill:

"SET IT AND FORGET IT."

Uh, JPP...hate to burst your infomercial trivia bubble, but SET IT AND FORGET IT belongs to Ron Popeil and the Ronco rotisserie!

 

[jetproppilot]

Uh, JPP...hate to burst your infomercial trivia bubble, but SET IT AND FORGET IT belongs to Ron Popeil and the Ronco rotisserie!

Are you seriously sure?

Its not George Foreman?laugh

Regardless, thanks Can.

The ropiv/sufenta combo, whether its George or Ron truly is a setitandforgetit.

 

[Jeff05]

it's definitely ron's rotisserie.

 

[Noyac]

We use Ropiv 0.1% with 2mcg/ml fent.

Haven't been called back in years. Seriously.