Anaesthesia, epidural

Only preservative free medicines may be used.

Local anaesthetics are administered through a catheter inserted into the epidural space at a spinal level appropriate for the surgery.

Aspiration and a test dose (2–3 mL) of local anaesthetic should be given to confirm catheter not intravascular or intrathecal. Subsequent doses should be fractionated (3–5 mL boluses).

  • Bupivacaine 0.5%.
    • Onset ±10 minutes.
    • Duration ±4 hours.
    • Motor block is less with lower concentrations.
    • Maximum dose 2 mg/kg.

LoEIII [36]