Used for opioid sparing analgesia and enhanced recovery in colorectal , cystectomy…
Recipe for intra-op +/- post-op lidocaine infusion (aka lignocaine for us Brits!)
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
Add 50mg ketamine to 50ml syringe. Run at 10mg per hour.
0.5mg/kg (preservative free) ketamine.
Prolongs action of caudal. Up to 12-16 hours.
Good for paediatric orthopaedics
A random post I came across…
We once saved a child admitted with severe scalds after trying to drink from a teapot spout using ketamine iv and some topical lidocaine.On laryngoscopy just saw a bubble of air escaping the swollen tissues and managed to push through a 2.5mm shouldered ET tube-The child was 5!
Fixed cardiac output state
Keep patient fast, full, constricted
SV or low PEEP to maintain filling