Ring Block, Epidurals, Fentanyl Patch
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What is the onset and duration of lidocaine?
- onset: < 5 minutes
- duration: 1 - 2 hours
What is the onset and duration of bupivacaine?
- onset: 15 minutes
- duration: 4 - 6 hours
What are the three nerves we block during a ring block?
- radial nerve
- medial nerve
- ulnar nerve
What are the two different ways to do a nerve block?
- insert the needle and inject the local anesthetic as we pull out (fanning)
- insert the needle at each individual nerve and insert a small amount of anesthetic at each location
What are the landmarks for an epidural injection?
L6 to midsacrum and the wings of the ilia
What positions can the animal sit in for an epidural injection?
- in sternal recumbency with the hind legs pulled forward
- in sternal recumbency with the hind legs pulled back into a frog leg position
Describe how to give an epidural injection?
- locate landmark
- insert needle at 60 degrees to the table
- slowly advance needle through the skin and remove stylet
- place a small bleb of saline or local anesthetic on the hub of the needle to create hanging drop
- hold the hub of the needle steady using both hands and slowly the advance the needle, it will pop through several ligament layers
- push firmly to advance needle into epidural space, the bleb on the needles hub will be drawn into the epidural space
- attach syringe and aspirate to confirm negative pressure
- the air bubble on the top of the fluid in the syringe should freely move with the fluid and should not compress or expand as you let off the plunger
- withdraw the syringe and needle and place finger over the hole
What are some complications to epidural injections?
What are some contraindications for epidural injections?
patients with obvious skin infections or inflammation at the site of injection, coagulopathy patients, and patients that are hypotensive or at risk for hypotension
What is the onset and duration of a fentanyl patch?
- onset: 12 hours
- duration: 3 days
How do we apply a fentanyl patch on a dog or cat?
- clip hair over application site in both directions
- wipe the area with DRY gauze
- remove adhesive back from the patch and gently lay the patch on the clipped area
- hold hand over the patch for 2 to 3 minutes
- write the date and time of application on patch
How can you remove a fentanyl patch?
use adhesive spray remover or Avon Skin So Soft
Should you place patients with fentanyl patches on heating pads?
What would you like to do?
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