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Epidural anesthesia for Cesarean sections

Epidurals for Cesarean delivery:

• Mix 20 ml of 2% lidocaine, 0.1 ml of 1:1000 epinephrine, 1 ml of NaHCO3, and 100 mcg of fentanyl
• Be sure to give the patient Bicitra and Pepcid
• Use 10-20 ml based on the level of the existing epidural analgesia
• Use aspiration prevention protocol
• Sample charting — PAE, to OR, sitting for spinal or LUD for LEC dosing, dosed or placed without difficulty, tolerated well, VSS, SMO, LUD, block to T4, PPD
• If block is spotty, 10 mg ketamine IV, can repeat
• Can give 0.5 mg/kg ketamine IV as a one-time dose for spotty block

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