Ultrasound Guided Nerve Blocks |
Anesthetic Recipes
Submitted by Davero6 on Tue, 01/04/2011 - 21:29
Anesthetic Recipes A Journal of Anesthetic Pearls from Anecdotal Experiences Disclaimer: There is No "One Size Fits All Approach to Anesthesia." Anesthesiology Training is an intense 3 year process where we are trained to look at each patient, their comorbidities and type of surgery. Based on this information we make our decisions. The below is simply a list of techniques that certain practitioners have had success with, and is not meant to be interpreted as a rule of thumb. I hope you find it informative... »
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First Trimester, NPO for D and C
I find this is a traumatic experience, goals are not only safe anesthesia, but to avoid the psychological trauma associated with the nature of the procedure.
It is my opinion, that adequate sedation is superior to general anesthesia because, you can minimize nausea, pain, and uterine relaxation (by avoiding volatile anesthetics)
So Midazolam 2mg (as soon as possible preferably while entering the room), glycopyrolate 0.2mg (anti-sialogue), Fentanyl 25-50mcg, Ketamine 20-30mg,
Put the legs up, and use Propofol 10-50mg to relax legs, if tolerated may titrate in another 25-50mcg Fentanyl, and then alternate ketamine 10-20mg, and propofol 10-20mg the remainder of the case.
You may consider an oral airway, use nasal cannula, and if obstructing perform jaw thrust and maintain patent airway
Decadron 4mg, zofran 4mg, and ketorolac 30mg IV (if not bleeding)
Advantages to technique... Patients awake quickly, with minmal pain, and minmal nausea