| - Recommended method | |
| - Use with caution | |
| - Do not use |
Labor & Delivery Regional Medications
| Drug / Dosages | Labor: Intermittent bolus (Epidural) |
Labor: Infusion (Epidural) |
Delivery (Epidural) |
C/Section (Epidural) |
C/Section (Spinal) |
| bupivacaine | TD + 5ml 0.25% onset: 10-20’ duration: 90-120’ |
TD, then • 0.125% plain, or • 0.0625% with 2 mcg/ml fentanyl start @ 8-12ml/hr |
TD +
5+5ml 0.25% onset: 10-15’ duration: 90-120’ ---------------------- ( 0.5% forceps/motor block) |
TD +
5+5ml 0.5% + 50mcg fentanyl, 5ml + 5 + ... [to T4] onset: 10-15’ duration: 90-120’ |
~12mg 0.75% hyperbaric (with dextrose) +/- 100mcg epi +/- 250mcg MS-PF |
| lidocaine | TD+
5ml 1% onset: 5-10’ duration: ~60’ |
TD + 5+5ml 1% onset: 5-10’ duration: ~60’ ---------------------- (or 2% for forceps) |
TD + 5+5ml 2% 50mcg fentanyl, 5ml + 5 + ... [to T4] onset: ~5’ duration: 60’ |
~70mg
5% hyperbaric (with dextrose) +/- 100mcg epi |
|
| chloroprocaine (Nesacaine) |
TD +
5+5ml 2% onset: 5’ duration: 45-60’ ---------------------- (or 3% for forceps) |
TD +
5+5ml 3% 5ml + 5 + ... [to T4] onset: 5’ duration: 45-60’ |
|||
| ropivicaine (Naropin) |
TD +
5ml 0.2% onset: 10-15’ duration: ~90’ |
TD,
then 0.1% with 2 mcg/ml fentanyl start @ 8-12ml/hr |
TD+
5+5ml 0.2% onset: 10-15' duration: ~90-120' |
||
| meperidine (Demerol) |
TD +
25mg in 5ml NS (PF) onset 5-15’ duration: 2-4hrs (up to 3 doses) |
TD* - Test dose of 3ml 0.25% bupivacaine with 1:200,000 epinephrine or 3 ml 2% lidocaine with 1:200,000 epinephrine to rule out intravascular/intrathecal injection.