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Speed of onset of local anaesthetics and another textbook correction!

Anaesthesia Coffee Break

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Adrenaline in the Epidural Top-Ups?

Lionel: We usually drop like 18 mils of 2% ligand cane, adding 100 mics of adrenaline. So that's roughly five mics per mil or one in 200,000. And then two mils of the sodium bicarb,. And then another two mils is the fentanyl that might be added onto that as well. The epidural space is so vascular that you can get rapid dispersion of your local and aesthetic adrenaline just gives you that margin of safety. Lignicane comes in acidic solution; when you add an acidic solution to a basic solution, you're going to decrease the pH.

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