Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Epidural anaesthesia and analgesiaEpidural anaesthesia and analgesiaSafer practice with epidural injections andinfusions[Dr Mark Porter, December 2007]A trust policy on this was formulated in response to National PatientSafety Alert number 21. It is a summary of principles to be appliedalong with detailed information on treatment of local anaestheticoverdose.The approved infusion is bupivacaine 1 mg per mL with fentanyl 2microgrammes per mL. This is available in three forms. Thesesolutions have no product licence and are therefore off label.• 500 mL bags prepared in Pharmacy.• 50 mL syringes supplied through Pharmacy.• 10 mL ampoules supplied through Pharmacy.Other fluid bags containing plain local anaesthetic solutions forepidural administration must not be stocked or used.Other infusions may be made up by a doctor at the discretion of aresponsible consultant but they not be handed over to non-medicalstaff for further care, until administration is finished and the patient isready to recover from their epidural administration. Regular use mustbe supported through clinical governance mechanisms, via theclinical director for the area concerned.Injections may be made up by a doctor at the discretion of aresponsible consultant. Regular use must be supported throughclinical governance mechanisms, via the clinical director for the areaconcerned.122 Anaesthetists Handbook January 2010