Low spinals in c-sections

[banister]

I think it totally depends on the OB you're working with. In residency we did 1.6 heavy + 15mcg fent + 150mcg duramorph for most and would place CSE if they're slow or repeat section.

Now in PP our group works with a wide range and I dose it mostly on who's operating, not really the patient. For a few of the super quick ones (20-25min skin to staple), I do 1.2 + fent/duramorph. Majority are between 30-50 min and I use 1.4 + fent/duramorph. A few are slower ~60 and I do 1.6 for them if repeat c/s. Never had to place a CSE after residency.

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[Gator7]

1.2-1.4 plus 20 fent 0.2 morphine is standard here. I personally just do 1.4. A couple peers from academic places do higher doses with a neo drip but surgeons are fast here so doesn’t seem necessary.

On rare occasion of a partial block will sit the patient back up and give 0.8 to 1.0 of just heavy no narcotic. Have noticed this is more frequent with bupi in the kit vs one in the pixis.