Simple dosing question for epidurals

[hrmm]

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Probably a dumb question but for epidurals, I read that the test dose is usually 3ml of 1.5% lidocaine with 1:200,000 epinephrine.


1. Does this mean total of 45mg of lidocaine and 15mCg of epinephrine?
2. How do you prepare this test dose? (eg. does lidocaine come in 1.5% vials? does epi come in anything besides 1:1000 vials? how do you dilute the epinephrine and then add it to the lidocaine to make 3ml worth?)

 

[Idiopathic]

the test dose usually comes in the kit. barring that, 3cc total volume with those concentrations can be made with 2.25cc 2% lidocaine and 0.75cc 1:50,000 epi

i dont think there is a commercially available 1:50K epi, so you would have to do the dilution yourself (0.2cc of 1:1000 epi diluted to 10cc total volume will give you 10cc of 1:50,000). i havent ever done this but im sure others have a nice easy way to go about making your own test dose.

ultimately, if you carefully add 40-50mg lidocaine to 10-20mcg of epi you should have a fine test dose, even if it is just under or over 3cc. there is no rule about the volume being 3cc exactly - the dose is more important

 

[excalibur]

It is a pre-prepared vial. The vial in the kit already has a concentration of Lido 1.5% and epi 1:200,000. You just draw 3 mLs of it

 

[jwk]

I've never seen an epidural kit that didn't have an ampule of local with epi to use for a test dose. If for some reason yours doesn't have it, I would assume you have vials of lidocaine with epi - doesn't really matter 1% or 2% - since that is frequently used for dosing epidurals. Preservative-free of course 😉

 

[sevoflurane]

2. How do you prepare this test dose?

Magic... We get 2 rotations during residency in magic and wizardry. 😉

 

[GoldnLead]

Magic... We get 2 rotations during residency in magic and wizardry. 😉

I did an extra two months of smithing and bow weapons.

 

[hrmm]

The different responses in this thread accurately describe exactly how SDN works.

Thanks everyone for the answers.

 

[sevoflurane]

The different responses in this thread accurately describe exactly how SDN works.

Thanks everyone for the answers.

Tongue and Cheek buddy. Idio, Excalibur and JWK covered your questions in full. I was just having a little sdn fun. 🙂

 

[RT2MD]

The different responses in this thread accurately describe exactly how SDN works.

Thanks everyone for the answers.

Yup, exactly why I like it here!

 

[sevoflurane]

Yup, exactly why I like it here!

Yo home-E:

Iron Maiden and Megadeath at the sprint center in KC!!!

If you've never seen Maiden live, it's worth it! Megadeath is just icing on the cake. 😍

 

[KLPM]

Don't do it OP.

 

[RT2MD]

Yo home-E:

Iron Maiden and Megadeath at the sprint center in KC!!!

If you've never seen Maiden live, it's worth it! Megadeath is just icing on the cake. 😍

Nice! Yeah, I've never seen Maiden. I'm in Colorado that week for an away, though! Are you hitting it up?