Tag Archives: analgesia

Peri-op lidocaine infusion

Used for opioid sparing analgesia and enhanced recovery in colorectal , cystectomy…

Recipe for intra-op +/- post-op lidocaine infusion (aka lignocaine for us Brits!)

Lidocaine 1%

Loading dose: 1.5mg/kg over 10min

Maintenance intra-op and post-op: 1% in 50ml syringe at 1.5mg/kg/hr

Post-op use 0.4% lidocaine (in 250ml bag)

Dose range 0.5-2mg/kg/hr

MONITOR FOR LOCAL ANAESTHETIC TOXICITY SIDE EFFECTS!

Use IBW if BMI>30

Optional extra:

Add 50mg ketamine to 50ml syringe. Run at 10mg per hour.

Ref: http://prc.coh.org/FF%20LidoIVPer12-10.pdf

 

RDH

Clonidine

pre-synaptic alpha-2 adrenoreceptor agonist

Uses:

  • prolonging duration of LA for nerve blocks/ epidural
  • sedation and analgesia in ICU
  • opiate and alcohol withdrawal
  • chronic pain, regional pain syndromes
  • hypertension
  • diagnosis of phaeochromocytoma

Caution:

  • Bradycardia
  • Hypotension
  • Sensitivity
  • Porphyria
  • May cause initial hypertension

Dose

  • IV: 1-5mcg/kg bolus (adult), 1-2mcg/kg bolus (paeds)
  • Epidural: 1mcg/kg (up to 150mcg)