Inserted a epidural for inguinal hernia patient with COPD + IHD .single shot uneventful.gave 3 cc of 2% adr.xylocaine,followed by 10 cc of 0.75% ropivacaine.Action till thighs. ?? ??waited ;then injected 5cc more.action till ing ligament.After 10 Min's 5cc more.surgeon ready with scalpel on my head.(I had already wasted his so much precious time.).7cc more after 10minutes.pt draped.
I gave 1 MGM fulsed .spo2 94% with nasal o2.surgeon checked with toothforcep action till T10 app.(Everyone happy.)With skin incision patient started screaming
???All eyes on me asking for option.
???with total dose of ropivacaine
1.can I change to epidural sensorcaine.was EP cath a problem.
2.cant dare to give GA to this pt in this setup.
3.can I remove the cath and give spinal.scared about hypotension.
4.Ask the surgeon to supplement with ing block?.Then total so much ropivacaine+his 25ml of 2% adr xylo with 0.5% sensorcaine...
???Plus cant give much iv supplements with his kind of lungs.
Your suggestions and experiences awaited.