Added: 3 years ago
From: yrpeng
Views: 26,518
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  • Hmm. Much better to use the 2hz setting (not the 1hz) - needle movement is only half as far between stimuli which is much more precise. But worst of all, you inject a large volume of LA without aspirating first. One day the needle-tip will lie in a blood vessel, and you will learn first hand the meaning of local anaesthetic toxicity, and I hope your patient will survive.

  • You can see that I did aspirate twice in the block. By the way, the LA contained epinephrine (1:200000), I always listen to the heart beat to find if increase of heart rate happens.

  • Fair enough - wasn't too obvious to me.

    Forget your 1:200K epinephrine affecting the hr is as an early warning of LA toxicity. I presume you asked your patient to inform you immediately if they notice lips or tongue paraesthesiae, and aspirated gently every 5 mL.

  • Injecting high volumes is a thing of the past. 15-20 mls of volume are much safer, often spare the phrenic, and give results that are just as good.

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